Is there a Difference in Complications following Wisdom Teeth Removal when using Local Anesthesia versus General Anesthesia?

An interesting article titled “Retrospective multivariable comparison for complications of third molar surgery performed under general versus local anaesthesia” written by Beteramia et al. appears in Oral Surgery in 2019 (vol. 12, pp. 96-103). The article seeks to explore if there is a difference in the amount of complications that occur during or after wisdom teeth surgery when using local anesthesia or when using general anesthesia. In the article the authors discuss complications that can happen during wisdom teeth removal including excessive bleeding, injury to the inferior alveolar and lingual nerves, damage to the adjacent second molar, alveolar bone fracture, and displacement of tooth fragments into fascial spaces and complications that can happen after wisdom teeth removal including alveolar osteitis (dry socket), a secondary infection, and hemorrhage. These complications are discussed more over at http://www.teethremoval.com/complications.html. The authors further discuss how … Read more

AAOMS Pushes Back on Anesthesia Guidelines for Pediatric Patients

Earlier this year in 2019, the American Society of Anesthesiologists (ASA), the Society for Pediatric Anesthesia (SPA), the American Society of Dentist Anesthesiologists (ASDA), the Society for Pediatric Sedation (SPS), the American Academy of Pediatric Dentistry (AAPD), and the American Academy of Pediatrics (AAP) put out updated guidelines regarding the use of deep sedation and general anesthesia for children at a dental facility. The ASA, SPA, ASDA, and SPS put out a separate distinct set of guidelines from the AAPD/AAP. These guidelines are available from https://www.asahq.org/advocacy-and-asapac/advocacy-topics/office-based-anesthesia-and-dental-anesthesia/joint-statement-pediatric-dental-sedation and the June 2019 edition of Pediatrics in an article titled “Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures” written by Coté and Wilson, which was previously discussed in the blog post Updated Sedation Guidelines in Dentistry for Children. The guidelines are slightly different but the … Read more

Oral and Maxillofacial Surgeons Using Simulation to Improve Preparedness for Adverse Events with Sedation and Anesthesia

According to the July/August 2019 edition of AAOMS today (vol. 17, no 4) the American Association of Oral and Maxillofacial Surgeons (AAOMS) has launched a new National Simulation Program allowing for members and staff to practice techniques on manikins. This can allow for better preparedness by receiving feedback on areas that may require additional training. The same simulated events are given to all participants which allows for objective assessments. The courses can offer instant feedback and point out any deficiencies by the surgeon. The goal of such simulation is to improve patient outcomes. AAOMS currently offers simulation programs in Minnesota and South Carolina. A particular focus on the simulation is on training oral surgeons for preventing events that can be devastating such as a death or brain injury. Thus one focus of the simulation is on Basic Emergency Airway Management … Read more

Profit Motives in Oral and Maxillofacial Surgery Utilizing Sedation

Recently on this site it was discussed how guidelines have come out from the American Academy of Pediatric Dentistry (AAPD) and American Academy of Pediatrics (AAP) recommending when deep sedation or general anesthesia is given to children in dental offices there should be two trained individuals present. One individual should provide the dentistry and the other individual is responsible to administer the sedation or anesthesia and to observe the patient for any adverse events. This goes against the single provider model that has been advocated by the American Association of Oral and Maxillofacial Surgeons (AAOMS) and is typically utilized for wisdom teeth removal in the United States of America, where the oral surgeon performs both the dentistry and the administration of sedation or anesthesia. Some have criticized the AAOMS position of a single provider model for its focus on profit … Read more

Updated Sedation Guidelines in Dentistry for Children

Recently new guidelines have been issued regarding the use of sedation for dental procedures performed on children. In the past on this site some scrutiny has been placed on sedation provided to children during dental procedures because of many deaths that have occurred, see for example What to Ask the Dentist Before Children Have Sedation and Pediatric Dental Death in Cambridge, Ontario, Canada Spurs Comments on Dental Anesthesia. In the June 2019 edition (vol. 143, no. 6) of Pediatrics in an article titled Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures written by Coté and Wilson updated guidelines for the use of sedation in dentistry is provided. These guidelines were updated for the American Academy of Pediatric Dentistry (AAPD) and American Academy of Pediatrics (AAP) for the first time in … Read more