Updates on Anesthesia Provided by Oral and Maxillofacial Surgeons

Recently, it has come to my attention that the American Association of Oral and Maxillofacial Surgeons (AAOMS) has released a new white paper titled “Office-Based Anesthesia Provided by the Oral and Maxillofacial Surgeon,” in 2013, located over at http://www.aaoms.org/docs/papers/advocacy_office_based_anesthesia.pdf. This data contains some important data from the OMS National Insurance Company (OMSNIC) which to my knowledge had been previously closed. This data is Anesthesia Morbidity and Mortality Data from 2000 to 2010  for a total of 29,975,459 in-office anesthetics (conscious sedation, deep sedation and general anesthesia) provided by oral and maxillofacial surgeons in their offices. It was found from this data that the ratio of office fatalities/brain damage per anesthetics administered is 1 to 365,534.  I had long wondered what this data showed as I have previously looked at numerous studies attempting to determine how many deaths occur when anesthesia … Read more

What is the Prevalence of Patients with Asymptomatic, Disease-Free Third Molars (Wisdom Teeth)

An interesting article titled “How Many Patients Have Third Molars and How Many Have One or More Asymptomatic, Disease-Free Third Molars?” appears in the September 2012, supplement 1. (vol. 70, issue 9) of the Journal of Oral and Maxillofacial Surgery written by Thomas B. Dodson, DMD, MPH (pg. S4-S7). The article seems to attempt to arrive at an answer to the question of how many patients really have a wisdom tooth (third molar) that is not causing problems and that has no disease. In the article Dr. Dodson recommends that patients are divided into 4 different categories when having their wisdom teeth evaluated. symptomatic, disease present (based on history and radiological examination) symptomatic, disease absent (includes teething and vague pain symptoms unrelated to wisdom tooth) asymptomatic, disease present (disease is evident from radiological findings or clinical exam but not patient … Read more

Lessons from Medical Litigation of Dentists

Back in June of 2013, I discussed in the post Lessons from Medical litigation in oral surgery practice several lessons that can be learned upon exploring lawsuits occurring in an oral surgery setting. An interesting post on the same topic but applied to dentists as a whole was just written earlier today in DrBicuspid, titled “When a dentist becomes the defendant,” by Meghan Guthman (October 7, 2013, source: http://www.drbicuspid.com/index.aspx?sec=sup&sub=pmt&pag=dis&ItemID=314397&wf=1660“) Apparently this article was already written in the American Student Dental Association in their summer 2013 issue and was just a reprint. The article discusses some data gathered by Medical Protective which is a malpractice insurance company. Their data shows that the average payment to a plaintiff in a dental malpractice lawsuit is $65,000. Around 20% of their dental malpractice cases between 2003 and 2012 involved a tooth extraction with the average … Read more

Potential Risks of Surgery for Wisdom Teeth (Third Molars)

M. Anthony Pogrel in his article “What Are the Risks of Operative Intervention?” in the Journal of Oral and Maxilofacial Surgery vol. 70, pp. 33-36, 2012, suppl. 1, goes into complications associated with removing impacted wisdom teeth (third molars). I have previously explored this topic in detail over at http://www.teethremoval.com/complications.html. Although I did a poor job of distinguishing actual complications from negligence. In the article, Pogrel describes how studies have indicated that around 10% (1 in 10) of people undergoing removal of third molars may suffer from a complication. However, most of these complications are mild and will completely resolve in time. Pogrel states “Complications from M3 removal can be divided into 2 groups: those that are short-lived and self limiting, including bleeding, inflammatory complications such as surgical site infection and alveolar osteitis, or “dry socket,” drug reactions, displaced crowns … Read more

Association Between Partially Erupted Mandibular Third Molar and Caries in Distal Second Molar

An interesting article titled “Association between the presence of a partially erupted mandibular third molar and the existence of caries in the distal of the second molars,” appears in the International Journal of Oral and Maxilofacial Surgery by S. G. M. Falci and et. al. (October 2012, pp. 1270-1274). The article mentions how previous studies have shown that caries on the mandibular second molar due to the presence of partially erupted third molars has varied between 7% and 32%. The article criticizes prior work where studies based their prevalence data on panoramic radiographs which is not as good as periapical radiographs when diagnosing caries. The authors state “The lack of sample characterization, the absence of sample calculation, the deficient or inadequate statistical analysis and the absence of a description of the eligibility criteria, discredits the scientific evidence of these previous … Read more