complications

Planning Intravenous Sedation for Wisdom Teeth Surgery

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An article (in press at the time of writing this -2012) appears in the International Journal of Oral and Maxilofacial Surgery titled “Does planned intravenous sedation affect preoperative anxiety in patients?” by M. Seto, Y. Sakamoto, H. Takahashi, R. Kita, and T. Kikuta. The authors set out to evaluate The Spielberger’s State-Trait Anxiety Inventory (STAI) which can be used to evaluate levels of state and trait anxiety. State anxiety is defined as a subjective feeling of nervousness, whereas trait anxiety is defined as an individual’s underlying tendency to perceive a situation as stressful or threatening. One hundred and eleven (111) Japanese patients who were scheduled to have wisdom teeth extracted under local anesthesia were evaluated. STAI evaluates the degree anxiety based on 5 stages. The article states “The authors assessed preoperative anxiety using STAI at the initial visit and recommended … Read more

Improving Patient Safety: Updates on Oral and Maxillofacial Surgery

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In a recent blog post I discussed how a few new videos have appeared in recent months related to oral and maxillofacial surgery Videos Related to Oral and Maxillofacial Surgery. The American Association of Oral and Maxillofacial Surgeons (AAOMS) has also updated several sections of their website in the last year or so. They now have a section titled Orthodontics and Oral Surgery where they have videos related to showcasing various techniques that oral and maxillofacial surgeons and orthodontists perform. In addition they have updated and written a new page titled “Culture of Safety“. The page is a welcome addition and discusses how safety is the number one priority in the oral and maxillofacial surgery office. Now I wanted to take a moment to respond to this page and some other developments I have seen lately across the blogosphere. 1) … Read more

The Misbehaving Tooth Fairy

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In the article “The tooth fairy and malpractice” by Sian Ludman, Hamid Daya, Polly S Richards, and Adam Fox, in BMJ Christmas 2012, 345, e3027, a very interesting discussion is made of the tooth fairy. The article states “We are concerned that the actions of the mythical character at the root of this report must be brought to the attention of the medical community, as it seems to represent the first signs of a worrying new trend in malpractice.” The tooth fairy is widely considered to be benevolent but the authors present a disturbing report. A discussion is made of an 8 year old who presented with a foreign body in the left external auditory meatus (which showed up on a CT scan). The image is in the report. The parents of the boy discussed how three years earlier the … Read more

Exploring Giving Antibiotics Before Third Molar Surgery (Wisdom Teeth Removal) in Spain

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An issue that one asks when having third molar surgery (wisdom teeth removal) is one whether should have antibiotics administered before or after surgery (or not at all). See for example http://www.teethremoval.com/antibiotic_resistance.html In a recent article appearing in J Evid Base Dent Pract 2012, issue 12, pp. 149-150, Manal A. Awad, reviewed a study exploring amoxicillin administration to those who were having wisdom teeth extracted. The original study was titled “Efficacy of amoxicillin treatment in preventing postoperative complications in patients undergoing third molar surgery: a prospective, randomized, double-blind controlled study,” by Lopez-Cedrun JL, Pijoan JI, Fernandez S, and Santamaria J, Hernandez G and appeared in the electronic 2011 version pages 5 -14, issue 69, number 6. It is well known that amoxicillin is useful in treating oral infections. In the study 123 healthy patients between the ages of 18 and … Read more

Looking at the Concept of Prevention in Dentistry

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An interesting article written by Jay W. Friedman, DDS, MPH, appears in J Evid Base Dent Pract, vol. 12, pp. 53 – 54, 2012. In the article a discussion of three different types of prevention is made. primary prevention secondary prevention tertiary prevention Primary prevention is described as the well known prevention in which one attempts to not have any dental caries, not have any periodontal disease, and not have any loss of teeth. This form of prevention is when one regularly brushes their teeth, flosses, has a dental cleaning, and radiographs performed. The author discusses how typically dentists recommend 6 month intervals between examinations and cleanings. He then says “Patients who form minimal calculus and have no periodontal disease likewise do not need semiannual prophylaxis, or additional service…Lacking evidence of need, this is not prevention but rather FUN (functionally … Read more