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 … Read more

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 … Read more

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 (I have mirrored it over at 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 … Read more

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 … Read more

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 … Read more