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Tag Archives: evidence based dentistry

Advocacy White Paper on Third Molar Surgery by AAOMS

Posted on 19. Dec, 2011 by .

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Recently the American Association of Oral & Maxillofacial Surgeons (AAOMS) issue a Press Release located over at http://www.prnewswire.com/news-releases/aaoms-white-paper-discusses-why-when-and-how-to-treat-third-molar-teeth-135889358.html

In the conclusion of the press release it states

“The AAOMS encourages patients and their families to talk to their general dentist, orthodontist or family physician to determine whether third molar surgery is indicated. If a decision is made to retain these teeth, regular dental check-ups and good dental hygiene to control or prevent periodontal disease are essential.”

The press release discusses a recent Advocacy White Paper released on Third Molar Surgery. This is located at http://www.aaoms.org/docs/evidence_based_third_molar_surgery.pdf

I think the this recent White Paper issued on November 10, 2011, is well worth the read for anyone considering having elective healthy wisdom teeth surgery performed.

The paper mentions some of the recent controversy of the medical necessity of removing erupted and impacted third molars.

Numerous references to the scientific literature are provided.

Of course as an adovacy paper it states

“ AAOMS fully supports the elective, therapeutic removal of impacted  third molar teeth that are not likely to erupt into a disease free position, whether the third molar teeth  exhibit symptoms or not, and preferably prior to the onset of periodontal or pericoronal disease”

Near the end of the white paper it states

“There is no pat answer, cookbook recipe, or  flow chart that is universally accepted regarding the decision making process. The presence of the third  molar teeth, their position within the jaws and or dental arches, the condition of the teeth and  associated teeth and structures, the presence or potential for pathology associated with the third molar  teeth must be considered carefully. The risks of complications involved with early treatment of third  molar teeth that are likely to cause problems versus the morbidity caused by retained third molar teeth  and subsequent treatment in an older patient must be weighed.”

Of course as an advocacy paper it is slightly biased towards surgical intervention.

There is discussion of a case in the literature

“of a patient who is “60 years old, had taken bisphosphonates, had undergone chemotherapy, aortic, and mitral valve  replacements”. She presented with acute cellulitis. Days of hospitalization, surgery, and rehabilitation  were necessary to restore her health”.

Of course as I like to point out a 60 year old who made it that long without problems from wisdom teeth is pretty good when compared to cases like mine of young healthy adults who had drastic and serious complications from wisdom teeth extraction as indicated over on the complications page http://www.teethremoval.com/complications.html

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Wisdom Teeth Surgery Survey

Posted on 03. Feb, 2011 by .

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I wanted to let those know who might be new to teethremoval.com that a 10 question survey on wisdom teeth removal is ongoing. If you are a longtime visitor and have not yet taken the survey or are a new visitor to teethremoval.com I hope you can spare a few minutes of your time and click on the link below to take the survey on wisdom teeth extractions.

http://teethremoval.polldaddy.com/s/6E8CF57E23BD9041

The survey is anonymous so your name and personal information will not be tied to the responses. Below are a few recent responses from the survey.  Thanks for your help! It makes a difference to those who may be considering have their wisdom teeth taken out.

Here is a recent survey response from a 29 year old woman who had 1 wisdom tooth removed who chose to elaborate on her wisdom teeth removal experience after completing the initial questions in the survey.

My lower left wisdom tooth had given me pain and infection twice in the past. During a flare-up of pain and infection, I went to the public dental hospital and the dentist suggested pulling the tooth. I asked what the possible complications were and he merely said that there are only two very rare possible complications: nerve damage causing numbness in the jaw or nerve damage causing an altered sense of feeling in the jaw. Counting those as my only possible hazards, I decided to have the pull. I was not given anti-biotics and was not told of any other possible complications, even when I failed to bleed at all (which I now know is the main cause of dry socket). I was not given pain killers and was sent home. The pain was intense and severe and the complications were many, including dry socket, infection to the socket, a bruised jaw from the excessive force used during the pull (in which the dentist held my lower jaw with one hand while pulling the tooth out with dental pliers with the other hand), muscle spasms along my jaw that resulted in a massive hard lump which prevented me from opening my mouth for two weeks, TMJ pain (which I have had before but was triggered again by the pull), and a chronic ongoing ear ache and persistent headache (although I have no history of headaches in my past) as well as chronic ongoing stabbing pain in my left cheekbone. I went back to the dental hospital four additional times, and each time I was not told anything about these symptoms. I have had to learn about them from internet sources like this one. And I now have a great distrust and fear of the dental field which I did not have before.

Here is an additional recent wisdom teeth removal survey response from a 16 year old girl who had 2 wisdom teeth extracted.

I am a singer and sinus complications have severely impacted my life. I have had one sinus surgery so far and am scheduled for a second one because of the sinus complications from my wisdom teeth removal. I’ve had constant sinus infections for over 2 yrs now.

If you are interested in seeing some additional previous survey responses, please view a  previous post on this blog regarding this wisdom teeth extraction survey.

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New Evidence Based Dentistry Site

Posted on 10. Apr, 2009 by .

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The American Dental Association has recently launched a new website dedicated to providing evidence based dentistry. You can visit the site at http://ebd.ada.org/

Upon reviewing the website, there are systematic reviews, clincal recomendations, and resources.

Resources link to other useful websites that may aid in finding evidence based health information. What is missing in this list is a link to the National Institute for Health and Clinical Excellence. However, there are numerous links to other sites in the U.K.

In addition what is missing are any clinical recommendations on wisdom teeth removal. As of now there are only 3 clinical recommendations. The list and information is short and hopefully this can grow in the future.

Even so, it is nice to see that the ADA recognizes the need for evidence based dentistry and is attempting to provide and link to this information so that others can view and read it.

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Dentists Reviewing Literature

Posted on 15. Aug, 2008 by .

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I think this is somewhat of joke; however, dentists are soon going to be getting their hands dirty reviewing dental literature. The American Dental Association (ADA) is starting to practice evidence based dentistry (EDA) as opposed to biased dentistry. They should have been doing this decades ago!

The recent ADA’s Evidence Reviewers workshop in late June of 2008 taught clinicians and researchers how to critically assess scientific literature and how and why critical summaries should be written.

“I was able to come away from the EBD reviewer workshop training with a dramatically new and refreshing perspective on evidence in dentistry,” said Dr. Joseph Hagenbruch of Harvard, Ill., a general dentist and incoming chair of the ADA Council on Dental Benefit Programs.

“More importantly, I was able to learn skills and techniques for use when reviewing dental literature for determination of document validity, reasonable applicability and even aspects of predictability.”

The participants were taught how to adopt an evidence-based approach to treatment planning as well as how to write concise one-page critical summaries of systematic reviews to help practitioners understand and use scientific findings.

“It was really exciting to be talking to the leaders in the field and learning from them the science of evaluating systematic reviews,” said Dr. Heather Hill, a general dentist and National Library of Medicine Fellow at Oregon Health and Science University. “They were focused on making the information succinct and relevant to clinicians.”

All of the reviewers received individual mentoring and feedback to further develop their skills in preparation of the critical summaries.

“It may sound naive or perhaps a bit cheesy, but the experience felt much like investigating a new frontier or planet that was overdue for exploration and our charge was to look under every stone, move every leaf of vegetation to make sure that nothing is missed and all the bases are touched in terms of examining evidence,” said Dr. Hagenbruch.

Getting involved in EBD research has been a satisfying experience for Dr. Hagenbruch, who over the years has often questioned some of the material he has heard during continuing education programs and in published studies he has read.

“At times I have experienced situations in which material being presented by the seminar speaker, in my opinion, was less than accurate or the individual was showing an obvious bias toward a product, piece of dental equipment or treatment technique,” he said. “On those occasions the thought always crossed my mind of how advantageous it would be to actually be able to serve within a group that sorted out the fact from the fiction, phony and fluff.

“The American Dental Association’s Evidence-Based Dentistry Program and its commitment, through membership involvement, to sort out and untangle things in an unbiased manner, seemed to me to be too favorable of an invitation to pass up,” he said.

Like Dr. Hagenbruch, Dr. Hill is enthusiastic about taking up the charge to get clinicians interested in EBD. She became involved in EBD because she enjoys dental research and having it ultimately make life easier for dentists and patients.

“Systematic reviews are the gold standard of EBD and I feel like I am just starting to understand their intricacies,” she said. “It is gratifying to be involved in this project from the beginning. I look forward to being able to use what we create.”

Go to the following link to learn more about the American Dental Association and Evidence Based Dentistry. The orginal article was written by Jennifer Garvin and is located here.

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