Tag Archives | controversy

Should the NICE Guidelines for Management of Wisdom Teeth (Third Molars) be Reevaulated?

An article titled “Changes in Demographics of Patients Undergoing Third Molar Surgery in a Hospital Setting Between 1994 and 2012 and the Influence of the National Institute for Health and Care Excellence Guidelines,” written by Vahe Petrosyan and Phillip Ameerally appears in the February 2014 issue of the Journal of Oral and Maxillofacial Surgery, pp. 254-258. The article discusses how National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) were published around 2000 recommending against prophylactic removal of wisdom teeth. This led to a reduction in surgeries performed. In the article the authors question whether or not the NICE guidelines on wisdom teeth should be updated. They mentioned a 2009 study which said 27% of previously symptom free wisdom teeth can become symptomatic after 1 year, especially those that are distoangularly impacted. In the article the authors looked at data from Northampton General Hospital in England which services around 0.7% of the population over the time period from 1994 to 2012. A total of 10,447 patients older than 16 years were treated during the study period. The mean patient age increased from 29 years in 1994 to 36 years in 2012, with the median […]

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Controversy Over Spinal Fusion

Debate over spinal fusion surgery continues to occur. A recent article tiled “Spinal fusions serve as a case study for debate over when certain surgeries are necessary,” appears in the Washington Post written by Peter Whoriskey and Dan Keating and published on October 27, 2013. (Note I have previously mentioned some of the controversy over spinal fusion in the post Tips to Prevent Medical Errors – AHRQ) The article mentions that spinal fusions being performed in the U.S. has risen over the years and that around half of the surgeries they reviewed don’t meet expert consensus on when the surgery should be performed. This article discusses a surgeon at a Florida hospital who was earning well over a million a year performing spinal fusions on patients. Auditors at the hospital began to wonder if all the cases were necessary and paid for an independent review which showed that 9 out of 10 cases was not medically necessary. A lawsuit emerged which provided several details on the financial arrangements between the doctor and the hospital. For example, the surgeon earned additional money beyond his base salary for each procedure after a certain threshold. The surgeons at the hospital were charging patients […]

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When Abstinence is Evidence-Based

I came across a 2012 talk Jay W. Friedman gave titled “When Abstinence is Evidence-Based: The Case Against Prophylactic Third Molar Extractions,” at the 2012 National Oral Health Conference. The PowerPoint for the talk is located over at http://www.nationaloralhealthconference.com/docs/presentations/2012/05-02/Jay%20Friedman.pdf (I have mirrored it over at http://www.teethremoval.com/When_abstinence_is_evidenced_based.pdf). For those not aware of Jay W. Friedman you can start by reading the post American Journal of Public Health Author Jay W. Friedman is 2009 Author of the Year and Looking at the Concept of Prevention in Dentistry. Some interesting graphics appear in the talk, a few which I have included in this post. The talk is very concise and to the point and very informative for anyone considering whether or not to extract wisdom teeth (third molars). I will now provide a brief overview of the talk, but encourage you to look at the full talk yourself. Like usual (see http://www.teethremoval.com/controversy.html) several jabs are taken at AAOMS (the American Association of Oral and Maxillofacial Surgeons). For instance, he mentions how AAOMS placed a 4 page ad in USA Today in 2007 and didn’t mention any potential complications from extraction. He says that even though AAOMS has changed the language on their website […]

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Controversy Surrounding Marijuana

I recently watched a very controversial documentary shown on Wealth TV (re-run had previously aired) titled Marijuana Miracle Cure 2 Wired for Weed. This came out a few months ago in 2013, and seems to be a follow up to their Marijuana Miracle Cure program from 2012. If you have not seen it, you may be able to catch another re-run on Wealth TV or you may be able to find the entire 1 hour program (including commercials) on YouTube. The documentary raises some interesting points about marijuana (aka cannabis) and it’s potentially medical properties. Now the first question, I have, is why does Wealth TV have a documentary on marijuana? It seems from the documentary that they are genuinely interested in the potential medical issues of marijuana. This is because of the focus and nature of the documentary, but there could be some other motive but this is hard to tell. The documentary does interview a medical doctor, several PhDs, and several patients who claim to have benefited from cannabis for medicinal purposes. Some of the history of marijuana is described including what led to it’s ban and what may prevent it from being labeled as having medicinal properties in […]

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Bupa Ends Covering Wisdom Teeth Extractions Deeming Them Unnecessary

There is a lot of debate regarding removing asymptomatic third molars (wisdom teeth). Those who argue against removing asymptomatic wisdom teeth (retaining) are often accused of trying to save the insurance industry money (See for example Rogue Dentist’s Crusade), while those who argue for extracting asymptomatic wisdom teeth for preventative purposes are often accused of being interested in making more money due to the commonly used fee for service health care system. Somehow in the hoopla the patient’s health seems to take a back seat to some party making (or saving) money. Recently an article came out in London in the Times titled “Health insurer’s chief takes the knife to ‘unnecessary surgery” by Nic Fildes and Andrew Clark, March 13, 2013. The article opens by saying “Want to get your wisdom teeth extracted? Don’t ask Bupa, which is cutting back on what it deems unnecessary surgery in an attempt to improve profits in its ailing British business.” The article states that the CEO of Bupa says that it won’t pay for wisdom teeth extractions for patient’s who aren’t in pain. The CEO is quoted as essentially saying that there is no reliable research that suggests that removing healthy teeth have health […]

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