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U.S. Dental Schools Teaching little on Sleep Disorders

Posted on 13. Aug, 2010 by .

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American adults suffer from sleep disorders and the number is quite large, around 70 million. U.S. dental schools are not teaching their graduating soon to be dentists the importance of screening their patients for sleep disorders.

A survey sent out by researchers from the University of California — Los Angeles (UCLA) School of Dentistry,  indicates that dental students spend an average of 2.9 instruction hours during their four years of dental school studying sleep disorders.

The main problem is for those 18 million Americans that suffer from Obstructive Sleep Apnea (OSA). It estimated that 80 % to 90 % of patients with OSA are not diagnosed and this can consequently raise the patients risk for many diseases and problems.

The researchers feel since dentists see patients on a regular basis, they can notice early warning signs of sleep disorders. This greatly makes sense and thus U.S. dental schools should increase the amount of time during the 4 years of study that students receive on sleep disorders.

Source: http://www.sciencedaily.com/releases/2010/06/100605112529.htm

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Western Dental injuries and pain

Posted on 08. Aug, 2010 by .

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I found some interesting pieces from ABC 7 KGO-TV San Francisco, CA. The articles and videos are about the second largest HMO in the state of California called Western Dental.

Numerous people are profiled talking about things such as nerve damage following wisdom teeth removal, people’s healthy teeth being pulled out and being replaced with dentures,  a syringe injecting bleech into a girl’s sinus during a root canal, and putting too much filler into the root of a woman’s teeth during a root canal and causing severe pain.

Of course Western Dental defends by not admitting wrongdoing but then lawsuits result and a settlement is reached in some cases. In other cases Western Dental has not paid for subsequent follow up treatment.

To see the videos and read more of the articles visit these 2 links.

http://abclocal.go.com/kgo/story?section=news/iteam&id=7583317

http://abclocal.go.com/kgo/story?section=news/iteam&id=7585208

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Physical Causes of HPA Axis Hyperactivity and Smaller Hippocampus Volumes Linked to Depression in Multiple Sclerosis

Posted on 07. Aug, 2010 by .

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I found this new research to be quite interesting.   Multiple sclerosis (MS) is a disease in which the fatty myelin sheaths around the axons of the brain and spinal cord become damaged.  Depression has been found to be present in nearly 50% of MS sufferers.

It is clear though that the depression is not just a psychological reaction to having the disease.  This is because in patients the depression occurs and it has been found to not be related to how severe one’s MS is and it also can occur at different stages of MS.
Recently researchers at UCLA have showed a physical cause for depression in those patients suffering from MS atrophy of a specific region of the hippocampus which is part of the brain.

The researchers also found a relationship atrophy of the hippocampus and hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis. It is believed that the dysregulation of the HPA axis may play a role in the atrophy of the hippocampus and cause depression.

“Depression is one of the most common symptoms in patients with multiple sclerosis,” Gold said. “It impacts cognitive function, quality of life, work performance and treatment compliance. Worst of all, it’s also one of the strongest predictors of suicide.”

The researchers were able to come to these conclusions by examining three regions of the hippocampus in MS patients and comparing them to healthy patients without MS. Further the researches measured cortisol levels which is a stress hormone produced by the HPA axis.

Gold et al.Smaller Cornu Ammonis 2-3/Dentate Gyrus Volumes and Elevated Cortisol in Multiple Sclerosis Patients with Depressive Symptoms. Biological Psychiatry, 2010.

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Legal Standpoint of Oral Surgery Complications

Posted on 30. Jul, 2010 by .

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As I have written on my website, I disagree with wisdom teeth removal from a legal standpoint (in addition to scientific). Essentially what I argue is that if you have your wisdom teeth extracted and suffer a complication that is not one of the better known you may not recover any money and be left with the pain, suffering, and loss of earnings for the rest of your life.

A recent oral surgeon lawsuit after wisdom teeth removal helps reaffirm my previous remarks.  The article states that Cynthia Thompson sued Dr Princell because he did not disclose all the risks of surgery and she suffered a neurological syndrome (specifically a damaged inferior alveolar nerve) as a result of the wisdom teeth removal.

“During the trial, 3 oral surgeons told the court that they knew little about the causes of the neuropathic pain syndrome and its association with extraction of wisdom teeth, according to court documents.”

This case occurred in the state of Georgia. Hence due to the complication of nerve damage occurring to Cynthia and the fact that the only risks that need to be disclosed before oral surgery are the most common ones (of which I have previously discussed with a lawyer), Cynthia is left with permanent nerve damage as a result of elective wisdom teeth removal and receives no compensation for her suffering, pain, and loss of earnings.

I personally have a problem with this case though as inferior alveolar nerve damage is a much more well known complication of wisdom teeth removal than some of the others. I argue that it is very important for oral surgeons to take data on what complications occur by their patients and release this data to other oral surgeons so that it can be compiled. I also argue that the legal system should be change to stop rewarding American doctors for malpractice.  The norm in America is to remove healthy wisdom teeth that are impacted but this is not the norm in other countries such as Britain.

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Dental Needle Could be Replaced

Posted on 20. Jul, 2010 by .

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I find this study to be quite interesting as I have had anesthesia delivered directly in my nose before in an attempt to prevent my constant 24/7 headache.

New evidence has emerged that a common local anesthetic, when administered to the nose as nose drops or a nasal spray, travels through the main nerve in the face and collects in high concentrations in the jaw, teeth, and structures of the mouth.

William H. Frey II and colleagues found that drugs administered to the nose travel along nerves and go directly to the brain, although I really don’t think this finding is novel. One of those nerves is the trigeminal nerve, which brings feelings to the face, nose and mouth. Until now scientists never paid much attention to intranasal drugs passing the nerve in the nose and how it might reach the teeth, gums and other areas of the face and mouth to reduce pain sensations in the face and mouth.

Researchers in this study found that lidocaine or Xylocaine, sprayed into the noses of laboratory rats, quickly traveled down the trigeminal nerve and collected in their teeth, jaws, and mouths at levels 20 times higher than in the blood or brain. This method thus has implications for providing a targeted method for treating  trigeminal neuralgia, migraine, dental pain, and nerve damage.

The researches say an improved future location to administer anesthetic is the maxillary sinus. I question if this is truly a good idea as injecting lidocaine or Xylocaine can cause many symptoms and complications. I feel like this may cause some localized inflammation which would lead to dryness and bleeding in the maxillary sinus. The maxillary sinus would thus be implicated more than it needs to in dental procedures. I would be interested in hearing the opinion of an Ear Nose and Throat Doctor on this issue.

I touch on some of the details of the nerves in the head on my website at http://www.teethremoval.com/nerve_damage_in_depth.html.  I also show the location of the maxillary sinus which is clearly visible in a dental x-ray at http://www.teethremoval.com/complications.html. I also discuss how I had maxillary sinus surgery on my website as after I had my wisdom teeth removed and developed a severe 24/7 headache I had an MRI done. The only abnormality was found in the maxillary sinus. The details of this are explained more on my homepage.

Source: Neil J. Johnson, Leah R. Hanson, William H. Frey. Trigeminal Pathways Deliver a Low Molecular Weight Drug from the Nose to the Brain and Orofacial Structures. Molecular Pharmaceutics, 2010: 100510131956016

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