Oral and Maxillofacial Surgeons Current Perspectives on Opioid Prescribing

Recently, both insurance companies and politicians in the U.S. have intensified their efforts to limit patients undergoing wisdom teeth surgery to have access to opioids to manage their pain. See the posts on this site: 1) Insurance Companies Limiting Access to Opioids After Wisdom Teeth Surgery and 2) The Effect of Opioid Prescription Limits For Wisdom Teeth Removal. Such efforts have intensified due to recent research showing that opioid prescriptions taken by young adults following wisdom teeth removal has contributed to the opioid addiction and abuse epidemic in the U.S. However, lost in these conversations is the perspectives from oral and maxillofacial surgeons. According to the 2017 white paper by the American Association of Oral and Maxillofacial Surgeons (AAOMS) titled “Opioid Prescribing: Acute and Postoperative Pain Management,” these surgeons feel: “… the practitioner-patient relationship must be upheld, allowing for practitioner … Read more

Delivering Sedation in Dentistry

It has become increasing popular to deliver sedation to patients receiving dental work. Sedation is defined as the deliberate drug-induced depression of consciousness used to reduce anxiety and awareness associated with unpleasant medical procedures. Sedation is used to reduce anxiety.  In some cases dentists or oral surgeons deliver both the dental work and the sedation, while in others there is a separate anesthesiologist to do so. One should always verify proper training and license prior to undertaking any sedation from a healthcare professional. Sedation is generally considered very safe as long as it is performed by an appropriately trained practitioner in a monitored environment. Sedation dentistry uses different approaches depending on personal choice and comfort. In the order of increasing anesthesia these are local anesthesia, minimal sedation, nitrous oxide/oxygen, moderate (conscious) sedation, deep sedation, and general anesthesia. A more thorough discussion … Read more

TeethRemoval.com in the Scientific Literature

Readers of this blog may sometimes not take the scientific merit of this site very seriously. Even so the site attempts to provide some up to date research on wisdom teeth (also known as third molars), dentistry, and other topics in medicine. In the past years several pages of this site including http://www.teethremoval.com/complications.html and http://www.teethremoval.com/dental_deaths.html have been cited in scientific article publications and posters. I wanted to draw attention to three instances of this occurring. First, an instance of citing the complications page came in an article titled “Time to Remove Your Wisdom Teeth!?” written by Michelle G. Tran from University of California, Davis appearing in the Lent 2013 edition (vol. 18, University of Cambridge) of the Science in Society Review by the Triple Helix, pages 20 to 21. See http://camtriplehelix.com/archive/journal/issue/18.  This is the University of Cambridge site but it appears there are 18 universites that … Read more

Influencing Government: Perspectives from U.S. Oral Surgeons

As has been discussed before on this site and blog, The Journal of Oral and Maxillofacial Surgery is published on behalf of the American Association of Oral and Maxillofacial Surgeons (AAOMS). They of course have their own interests and seek to help get candidates elected in government with positions favorable to theirs. This is described a bit in the article Influencing Your Government by James R. Hupp  appearing in the January 2015 issue of The Journal of Oral and Maxillofacial Surgery (vol. 73, issue 1). The article discusses how voting in an election is only part of the story and advocacy stronger than one’s vote at the ballot box. The author states “Advocacy can take many forms. The one that comes to mind for most people is campaigning for someone running for office. Similarly, one can donate to a candidate’s … Read more

AAOMS Issues New Position Paper on Medication-related Osteonecrosis of the Jaw

Earlier in 2014, the American Association of Oral and Maxillofacial Surgeons issued a new position paper on Medication related Osteonecrosis of the Jaw (MRONJ) see http://www.aaoms.org/docs/position_papers/mronj_position_paper.pdf?pdf=MRONJ-Position-Paper. The condition in the past has been called Bisphosphonate-related Osteonecrosis of the Jaw but both antiresorptive and antiangiogenic therapies are associated with it so the name has been updated. MRONJ appears as non-healing exposed bone in the mouth and may affect patients undergoing intravenous cancer-related therapy or those treated with oral or IV bisphosphonates for osteoporosis. The paper states that patients may be considered to have MRONJ if the following characteristics are present: Current or previous treatment with antiresorptive or antiangiogenic agents; Exposed bone or bone that can be probed through an intraoral or extraoral fistula(e) in the maxillofacial region that has persisted for more than eight weeks; No history of radiation therapy to … Read more