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A recent article titled “A 40 years follow-up of dental arch dimensions and incisor irregularity in adults.” by Nokolasos, Tsiopas, Maria Nilner, Lars Bondemark, and Krister Bjerklin, appearing the The European Journal of Orthodontics Advance Access published October 19, 2011, explores how the jaw is affected over a 40 year time period.

The study started in 1949 with 22 males and 13 females (35 total) and after 40 years in 1989, 18 of these participants were still able to participate. Three dental stone study casts were made for the 18 participants who completed the 40 years of the study.

The authors state:

“The present study showed that the occlusion, overbite, and overjet was stable, but dentoalveolar changes occur in the adult dentition. In the anterior part of the dentition, decreases in arch length and width lead to anterior crowding. There was also an increase in dental arch width at the first permanent molar.”

The authors conclude the article by saying

“The dentoalveolar processes continue to undergo physiological changes throughout adult life. Of particular clinical relevance is the finding that decreases in arch length and depth result in a decrease in intercanine width and increased crowding of the anterior teeth. These findings have important clinical implications in orthodontic practice, particularly in treatment planning and long-term post-treatment stability/retention.”

A key finding from this study is “We can also eliminate wisdom teeth as the cause, because even people who have no wisdom teeth have crowded front teeth.”

This study indicates that dentists should take into account that the lower jaw shrinks a few millimeters with age and this can crowd the front teeth.

Additional Source: Dentistry.co.uk. Jaws shrink with age and impact on teeth. November 7, 2011. http://www.dentistry.co.uk/news/4584–Jaws-shrink-with-age-and-impact-on-teeth

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For everyone living in the United States I encourage you to:

URGE CONGRESS TO MAKE HEALTH CARE A SERVICE AND NOT A BUSINESS.

Here is the link to to write to Congress to https://writerep.house.gov/writerep/welcome.shtml

The last I heard Congress had a dismal 9% approval rating.

Here is also the  link to find your Senator http://www.senate.gov/general/contact_information/senators_cfm.cfm

So why should you write to Congress?

Well here is what other dental professionals are saying about my website.

“I know this is a bit wordy, but our professional reputation may have become tainted because of a few who have reached national notoriety in a negative light. I don’t know how prevalent such unethical practices are, but we should all remember that patients don’t get mad at one doctor or one office, they paint the whole profession. It’s up to all of us to keep that reputation high.”

Donna Domina. Is dentistry facing an ethical dilemma? October 25, 2011. http://www.drbicuspid.com/index.aspx?sec=sup&sub=pmt&pag=dis&ItemID=308952  Glen

“Why should we do the ethical and get nothing while the others trample on us.”

glenp via http://www.drbicuspid.com/index.aspx?sec=sup&sub=pmt&pag=dis&ItemID=308952  glenp

 ”Some others, he noted, have proclaimed ‘what they think is their rightful place’ within the nation’s health care system. “Not on my watch!” Dr. Calnon said emphatically, stirring applause from the delegates.”

 James Berry. Service to members, public top Dr. Calnon’s agenda. November 07, 2011. http://www.ada.org/news/6531.aspx

Others have resorted to calling me a hack.

The Declaration of Indepedence states:

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”

As described on Wikipedia http://en.wikipedia.org/wiki/Life,_liberty_and_the_pursuit_of_happiness

John Locke, in his 1689 “A Letter Concerning Toleration,” wrote that “Civil interest I call life, liberty, health, and indolency of body; and the possession of outward things…”

William Wollaston’s 1722 book The Religion of Nature Delineated describes the “truest definition” of “natural religion” as being “The pursuit of happiness by the practice of reason and truth.”

I believe that my website lists truthful statements of which I found from my research. If you feel any of the information is inaccurate, false, or wrong then send me an email.

I firmly believe that you should have the right to make a reasonable living as a dentist or oral surgeon performing dental care; however, it is my belief than in most cases regarding healthy wisdom teeth not causing problems they should not be removed as indicated at http://www.teethremoval.com/wisdomteeth.html

I also believe patients should be able to have the right to pursue the knowledge and facts and information concerning removing wisdom teeth before having the surgery performed.

Further I believe that anyone have surgery performed would expect their healthcare provider to be making recommendations in regards to the practice of reason and truth.

Unfortunately, the current medical system is a business that is based on a fee for service model.

Don’t blame me I didn’t make the system.

The system should be changed.

The fee for service model should be eliminated. 

In addition, it is unfair to ask medical professionals to have protection from liability hanging over their heads every step of the way which prevents them from sharing medical information amongst each other which prevents high quality care.

 URGE CONGRESS TO MAKE HEALTH CARE A SERVICE AND NOT A BUSINESS.

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Recently I indicated in a post over here http://blog.teethremoval.com/wisdom-teeth-advice-and-new-dental-schools/ that a New York Times article was run on September 5, 2011, by Roni Caryn Rabin which was titled “Wisdom of Having That Tooth Removed.” This article is located here http://www.nytimes.com/2011/09/06/health/06consumer.html

Recently a Letter to the Editor of the New York Times was written by the President of the American Association of Oral and Maxillofacial Surgeons, Arthur C. Jee, discussing this article located at http://www.aaoms.org/docs/media/LetterNYTimes-09-21-11.pdf

In the article he states

The AAOMS does not advocate for the “prophylactic extraction of wisdom teeth”

If this is in fact the case then I think the AAOMS should make this clear on their website.

The website on wisdom teeth http://www.aaoms.org/wisdom_teeth.php continues to say

“As you can see, it isn’t wise to wait until your wisdom teeth start to hurt you before you have them removed. “

Even so the wisdom teeth page on AAOMS has been updated a bit since the last time I looked.  It does mention at the bottom that you may keep your wisdom teeth after previously discussing many of the problems that wisdom teeth can cause if you keep them.

Further in the letter Dr Jee says

 ”an absence of symptoms does not equal the absence of disease; retained wisdom teeth frequently and unpredictably change position, eruption and periodontal status; over time even retained, asymptomatic wisdom teeth are more likely to exhibit progressive periodontal disease; and retained wisdom teeth with periodontal pocketing increases the risk for several broader conditions that are associated with increased systemic inflammation, including preterm birth and cardiovascular disease.”

In the letter to the editor Dr. Jee says that

“Oral and maxillofacial surgeons provide their patients the best advice based on a careful oral examination, appropriate imaging and tests, and frank discussions with the patient and caregivers”

As indicated numerous times on my website that is not representative of the kind of care I received.

In a recent article a college professor describes the experience of his 21 year old daughter who has impacted wisdom teeth when his daughter and him visited an oral surgeon in California http://blog.teethremoval.com/the-truthiness-of-extracting-wisdom-teeth-james-r-carey/.  The issues addressed and raised in that article do not appear to be frank discussions at all.

In addition, the informed consent forms I have reviewed http://www.teethremoval.com/consent_form.html, leave out numerous potential harmful risks of having wisdom teeth removed which I feel many should be mentioned for an elective procedure when there is ample time to prepare such as a chronic 24/7 headache and a scar on the check as indicated over at http://www.teethremoval.com/complications.html

Further, I think a frank discussion should mention the fact that healthy wisdom teeth are not extracted in the U.K. and explain the reasons why which is for the potential minor and major harmful risks of surgical intervention along with cost effectiveness as mentioned at http://www.teethremoval.com/controversy.html

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A recently study titled Direct Costs of Preventive Headache Treatments: Comparison of Behavioral and Pharmacologic Approaches appearing in Headache: The Journal of Head and Face Pain, 51 (6): 985 -991, June 2011, and written by Allison M. Shafer et al., finds that treating chronic migraines using inexpensive prophylactic medicines such as beta-blockers or tricyclic antidepressants and behavioral approaches such as relaxation training, biofeedback, cognitive behavioral therapy, and stress management are a low cost and effective treatment option particularly after 1 year of treatment.

The authors used a cost minimization analysis and found that after 1 year, the cost of minimal-contact behavioral treatment was cheaper than the least expensive headache treatment medications. Minimal-contact or home based intervention is when a patient sees a therapist for around 3 or 4 visits and  largely practices the behavioral techniques at home through the use of printed materials and audio recordings.

For those who would prefer more visits with a therapist the researchers also found that clinic-based behavioral treatment where a therapist is seen in 8 to 12 weekly sessions becomes cost competitive with medications within 6 months and cheaper than most of the medications available for headache prevention within 1 year.

The study concludes

“While behavioral interventions for headache have been well validated empirically and have garnered increasing acceptance in recent years, these therapeutic modalities are not widely integrated into the clinical management of headache patients. Broadscale integration into mainstream healthcare practice depends greatly upon more systematically addressing access as well as financial and reimbursement barriers associated with this valuable approach to care.”

Of course if money is not much of an issue it may be best to pursue all available options. However, this study is important to help save costs for those in need (and also the entire health system). I personally have experience with behavioral approaches for the treatment of my chronic headache brought on by having my 4 healthy wisdom teeth extracted as discussed on teethremoval.com.  I also have discussed medications I have tried as well. I hope that behavioral approaches for the management of headaches becomes more widely used and may be very useful and cheaper for some.

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By now I am sure everyone has at least heard that Joe Paterno has been fired as the head coach of the Penn State college football team due to child sex abuse allegations made against one of his former assistant coaches.

As discussed a few times on this blog and as indicated as a potential unfortunate risk of having wisdom teeth extracted there is the possibility of being sexually assaulted while under anesthesia to have wisdom teeth removed.

As expanded on and discussed at http://www.teethremoval.com/sexual_assault_under_anesthesia_for_wisdom_teeth_removal.html many of the drugs that dentists and oral surgeons give during the surgery can cause in rare instances sexual hallucinations. This means that it is possible for no repercussions and/or loss of license and/or jail time to occur and it can be difficult to distinguish between dreams and actual molestation in the court of law.

In one recent case discussed on this blog in 2009, at http://blog.teethremoval.com/oral-surgeon-sexual-assault-acquital/,  17 women accused an oral surgeon of sexual assault while he was performing surgery on them. The judge ruled that the women “thought” they were sexually assaulted due to the drugs that there were on and that no real sexual abuse occured.

In other cases of sexual assault occurring during dental procedures there have been clear cut cases of sexual abuse. In one case in 1999, a box full of Polaroid pictures of anesthetized semiconscious and blindfolded girls were found at a dental office. The pictures showed roughly around 15 young girls performing oral sex on the dentist.

Recently in the movie Horrible Bosses, Jennifer Aniston plays the character of Dr. Julia Harris, D.D.S., who is a  sexually-deprived dentist. Here is a photo from a scene in Horrible Bosses.

In 1996, a movie titled She Woke Up Pregnant was released.  The movie is about a dentist who sexually assaults his patients while they are under anesthesia to have surgery. In one of the cases one of the women becomes pregnant.

If you plan to have surgery at a dental or oral surgeon’s office make sure that nurses or other chaperones are present for the procedure so that sexual assault can be distinguished from a sexual hallucination if it were to unfortunately occur.

Source: Roger Hensley. Did Paterno deserve to get fired over allegations? November 10, 2011 http://www.stltoday.com/sports/columns/round-two/did-paterno-deserve-to-get-fired-over-allegations/article_6bd81c36-0bc6-11e1-b387-0019bb30f31a.html

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