Tag Archives | dentist

Bleeding After Dental Extractions in Patients on Warfarin

An interesting article titled “Postoperative Bleeding Following Dental Extractions in Patients Anticoagulated With Warfarin” written by Anthony Febbo and et al. appears in the 2016 Journal or Oral and Maxilofacial Surgery (vol. 74, pp. 1518-1523). The article sought to explore the risk of bleeding in patients on warfarin after dental extraction. Warfarin is the most common anticoagulant used in Australia which can be used to prevent life-threatening thromboembolic events, such as stroke and deep vein thrombosis from occuring in patients at risk. Varying viewing points exisist as how to best handle these patients when a tooth or teeth need to be extracted. Some options include stopping the anticoagulant before extraction or continuing to use it while local hemostatic techniques are used. However ceasing the anticoagulant could be deadly so it is not generally used. The therapeutic effect of warfarin is measured as prothrombin time and communicated as the international normalized ratio (INR) with most patients between a value of 2 and 3 for INR. Prior studies have shown a rate of bleeding after dental extraction of approximately 2 to 8% for patients on warfarin but this includes specialistic centers with highly trained dentists or oral surgeons. The authors sought to […]

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Filing Billing for Dentists to Help Patients

An interesting article titled “You want me to do what?” written by Douglas Auld appears in the March 2016 issue of JADA. The article discusses a patient who has an an abscess on a mandibular right third molar which requires extraction. The treatment was done in December and the patient had already used their full benefits from their dental insurance for the year. So the patient suggested to the dentist to bill for the extraction in January and also suggested to file it as a surgical extraction and apply the difference to his balance. The article asks if it is ethical for dentists to do any of this. The article states that a dentist has a duty to communicate truthfully with third parties. It says “A dentist who submits a claim form to a third party reporting incorrect treatment dates for the purpose of assisting a patient in obtaining benefits under a dental plan, which benefits would otherwise be disallowed, is engaged in making an unethical, false or misleading representation to such third party.” Therefore the dentist should file the claim with the correct date of service or wait until January to perform the treatment. The article says “A dentist who incorrectly describes on […]

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What Can a Surgeon Do to Prevent Opioid Abuse

An interesting article titled “The Surgeon’s Roles in Stemming the Prescription Opioid Abuse Epidemic” written by James Hupp appears in the 2016 Journal of Oral and Maxilofacial Surgery (vol. 74, pp. 1291-1293). The article describes the current challenges oral and maxilofacial surgeons are facing when it comes to prescribing opioids. This is because regulators and politicians are getting involved due to their perception of an opioid abuse problem. He mentions that Congress is considering legislation to address prescription drug addiction problems. The author wants surgeons to remember that there are legitimate reasons for giving patients who have had oral surgery such as wisdom tooth extractions an opioid medication.  Pain that interferes with a patient’s usual routines, their ability to consume enough fluids and calories, or their ability to sleep often requires a narcotic until the pain subsidizes. As such these patients should be prescribed opioids and surgeons ability to do so should not be taken away. Even so the author encourages surgeons to raise one’s threshold for using very potent narcotics, and potentially limit the number of doses prescribed to patients. In the article the author says “First, there is more and more data showing that many patients receive more potent and more doses of opioid medications than they need […]

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Can Playing Baseball in Youth Lead to Better Surgeons?

An interesting article by Thomas Dodson titled “Everything I Ever Needed to Know About Oral and Maxillofacial Surgery, I Learned Playing Baseball” appears in the 2016 Journal of Oral and Maxillofacial Surgery (vol. 74, pp. 1709-1710). In the article the author tries to tie in how the game of baseball can teach oral and maxillofacial surgeons much of what they need to know. The author opens by talking about how he is saddened by the lost of Dr. William Harrison Bell who was a prominent surgeon in the field. He then explains that himself and the doctor who passed were both very big into baseball as youths. Dr. Dodson played first base in college and Dr. Bell was a minor league player. Dr. Dodson said that all the doctors he has worked with at various institutions all have been enthusiastic about baseball. He wonders if there is something that causes oral and maxillofacial to like baseball. The author says “While baseball may seem to the unindoctrinated to be a bunch of players randomly chasing a ball, in fact, the flight of a hit is remarkably predictable based on the type of pitch being thrown. Fielders know exactly where to stand and how to execute a double-play with reflexive precision.” He […]

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Ten Tips to Prevent Tooth Decay

Below is an interesting inforgraphic that talks about ten tips to prevent tooth decay. This includes visiting your dentist regularly, brushing twice a day, brushing your tongue, using fluoride toothpaste, using mouthwash, flossing daily, considering dental sealants, limit snacking, drinking some tap water, and eating tooth-healthy foods. This infographic is from Sydenortho see http://www.sydenortho.com/

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