Hallucinations While Taking Anesthesia: Implications for Sexual Assault

In the past it has been discussed how in rare occasions patients (mostly young women) while having wisdom teeth surgery are sexually assaulted. This is discussed at http://www.teethremoval.com/sexual_assault_under_anesthesia_for_wisdom_teeth_removal.html and in several blog posts such as In Light of the Allegations of Child Sex Abuse at Penn State…, Dentist Who Groped Patients Sentenced to Jail, and Recent Cases of Dentist Assistant Sexual Assault During Wisdom Teeth Removal. Many times these patients go on to sue either the dental assistance or dentist or oral surgeon who committed the sexual assault. However, most of these same patients are given drugs during the surgery that can cause sexual hallucinations. Thus it is typical for the legal team defending the dental assistance or dentist or oral surgeon to argue that the patient was dreaming and no actual sexual assault occurred. In some cases it is … Read more

Comparing Injectable Anesthetics for Dentistry

A review articled carried out by the Cochrane Database of Systematic Reviews titled “Injectable local anaesthetic agents for dental anaesthesia (Review)” written by St. George et al. in 2018 (no. 7, art. no. CD006487) explored the success of local anesthetics used by dentists. Procedures in dentistry that use local anesthetics include endodontic treatment, placement of restorations, and extraction of teeth. The researchers wanted to determine if one form of anesthetic worked better than others in different scenarios. The researchers defined success for an anesthetic based on the absence of pain during the procedure. They sought out to also explore the speed of onset and duration of anesthesia as well as the systemic and local adverse effects. The researchers had a very thorough search that resulted in 123 studies which was later reduced down to 68 studies and compared 14 different … Read more

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