guidelines

Dentists Seek new Guidelines for Gum Disease

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An interesting article titled “When is periodontal maintenance not enough?: The need for clinical guidance,” appears in the Journal of the American Dental Association published on January 21, 2023, written by Stephen K. Harrel and et. al. The article discusses how dentistry should seek to make new guidelines that address the management of periodontal patients who have continued inflammation. In the article discussion is made of how scaling and root planing is typically the first treatment for periodontal disease does not always eliminate inflammation. The initial treatment of periodontal disease consists of the removal of biofilm and calculus and patient education to help them continue to maintain oral hygiene in the future. The authors feel that in the case when inflammation persists, dentists should discuss to the patient advanced therapies and the risks of not undergoing these therapies while also … Read more

Should the NICE Guidelines for Management of Wisdom Teeth (Third Molars) be Reevaulated?

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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

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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