How Jaws Shrink With Age and Does This Affect Wisdom Teeth Crowding?

A recent article titled “A 40 years follow-up of dental arch dimensions and incisor irregularity in adults.” by Nokolasos, Tsiopas, Maria Nilner, Lars Bondemark, and Krister Bjerklin, appearing the The European Journal of Orthodontics Advance Access published October 19, 2011, explores how the jaw is affected over a 40 year time period. The study started in 1949 with 22 males and 13 females (35 total) and after 40 years in 1989, 18 of these participants were still able to participate. Three dental stone study casts were made for the 18 participants who completed the 40 years of the study. The authors state: “The present study showed that the occlusion, overbite, and overjet was stable, but dentoalveolar changes occur in the adult dentition. In the anterior part of the dentition, decreases in arch length and width lead to anterior crowding. There was also an … Read more

The Cyberchondriac: Managing the Difficult Patient

There is an interesting series over at QuantiaMD on Managing the Difficult Patient. Presentations are available for viewing as long as you sign up for with your email. One such presentation was originally called The Patient Who Knows too much but has been changed to The Cyberchondriac. Mary Modahl  who is QuantiaMD Chief Communications Officer said after the original title was added  “‘The Patient Who Knows Too Much’ is a very poor title. Certainly a patient can never know too much. In every way, we’re supportive of doctors meeting their patients’ need for care.” Dr. Joseph Scherger, vice president for primary care at Eisenhower Medical Center in Rancho Mirage, California, defines a Cyberchondriac in the presentation: “This is a patient who is on the internet…indiscriminate with the material they are reading…they consider themselves an expert yet often their true medical … Read more

Health Care Costs in America

I came across a very interesting graphic illustrating many of the myths and facts about healthcare in the United States. The graphic illustrates some reasons for the high costs of healthcare including the myths and the truths. The myths include 1) americans smoke and drink too much, 2) america has a larger elderly population, 3) obseity in america skyrockets costs, 4) malpractice is out of control. I actually slightly disagree with #3 and #4. I think being obese in the U.S. is a real problem, see this graph from the OECD. Further one has to account for defensive medicine (as in doctors being scared of getting sued  and ordering more tests than really needed) in malpractice lawsuits. Graph below illustrates the % obese in each country shown. Source: OECD Factbook 2010: Economic, Environmental and Social Statistics. I believe the truths … Read more

The Well Informed Patient

In a recent editorial in the Journal of Oral and Maxillofacial surgery (vol. 69. page 1263, 2011),  titled “Shouldn’t All Clinical Research Be Scientific?”, Dr. Thomas B. Dodson,  talks to his fellow oral surgeon colleagues and says “Not only do we face rapid advances in science and technology, but we have new accountability from economic, legal, and regulatory challenges, as well as a new brand of well-informed patient.” I personally would hope that the well-informed patient are patients who are being informed by oral and maxillofacial surgeons and dentists. However, I do not believe that is really the case here. One question to ask is why patients in the past were not well informed? The other and more pressing question to ask is why are these patients still not being properly informed today? (This also applies to other doctors and … Read more

Malpractice Liability Damage Caps and Their Effects on Rural Doctors

According to a paper by David A Matsa. who is an economics professor their is an effect on medical malpractice liability damage caps. In other words, the amount of money you can get if you sue a physician if something goes wrong is capped and you can only get X amount back as determined by a law in your state. (I have discussed this issue on my website about the legal standpoint of wisdom teeth removal.) Matsa finds that “Back-of-the-envelope calculation using estimates presented… implies that the enactments of damage caps are responsible for approximately 17 percent of the increase in frontier rural specialists in these states since 1970.” Even so, Matsa finds that there really is no significant effect on physician supply for most Americans (those who do not live in rural areas). If you are interested in the … Read more