Tag Archives | oral surgeon

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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Wisdom Teeth Facts – From Symptoms & Occurrence to Extractions & Precautions

What are Third Molars? A permanent dentition typically consists of 32 teeth and third molars or wisdom teeth are the most posterior teeth present on each quadrant. They are located the farthest in a dental arch and are usually the last ones to erupt. The third molars are formed due to evolutionary factors but with modern lifestyle and eating habits, they are no longer necessary. This is why smaller jaws have inadequate space to accommodate the eruption of third molars and all they do is cause pain, infection and discomfort. When Do Wisdom Teeth Erupt & Why? Wisdom teeth usually erupt between the ages of 16 to 25 but they may also erupt at a later stage for some. According to popular belief, wisdom teeth were used by ancestors for grinding plant tissues. Since our ancestors had a huge mouth which accommodated more teeth for digesting cellulose, third molars became a part of the tooth development process. This is why most of the time wisdom teeth either remain submerged under the gum or erupt only partially. Indications of Extraction If the jaw is large enough to accommodate the eruption of third molars and if they are aligned correctly, an extraction […]

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Can Science Solve Our Problems?

An interesting article titled “Science and Conscience” appears in the 2015 Journal of Oral and Maxilofacial Surgery written by Thomas Dodson (vol. 73, pp. 2255-2256). The article opens by discussing a study by the NIH seeking to explore the differences in people with a systolic blood pressure of 140 mm Hg versus that of 120 mm Hg. The study was aborted with a year left in its duration. The study concluded achieving a target systolic blood pressure of 120 mm Hg reduced cardiovascular events by almost 33% and death by almost 25% compared with a group with a target systolic pressure of 140 mm Hg. The authors question why such a study was ever needed to be done because it seems so intuitive but later explains that our society today relies on science to achieve it’s high standards. The author then goes on to discuss how there is a growing anti vaccination movement to not give kids the vaccines against diseases like measles, mumps, and whooping cough. He then goes on to discuss how there is also a movement to no longer fluoridate the water in communities. He states that cavities can help be minimized by adding a small amount of fluoride to drinking water. In both […]

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Take Me Out! A Brief Guide to Tooth Extraction – Infographic

Extraction is usually the agreed upon option for teeth which have become damaged or decayed where they are no longer reparable. Extraction is also worth considering if your mouth is overcrowded or to reduce the risk of infection if your immune system has been compromised from receiving chemotherapy or an organ transplant. Tooth extraction or tooth removal is generally considered safe and any respectable dentist will be able to put the patient at ease prior to surgery. Patients who are especially apprehensive will be given a sedative to ease their nerves before the dentist administers anesthetic to the area surrounding the tooth that will be extracted. The entire procedure is carried out with great care and intricacy by a dental professional who considers the patient’s health a priority, so you can rest assured that the entire operation will be seamless. Prior to tooth extraction, it is important to provide your dentist or oral surgeon with your full health history. You must also abstain from eating, drinking and smoking in the hours leading up to the surgery. Also, be sure to have someone to drive you home afterwards, as you will be unable to drive if given certain types of anaesthetics. To find out […]

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Shared decision making in cases of conflicted evidence

An interesting article titled “When clinical evidence is conflicted, who decides how to proceed? An opportunity for shared decision making,” appears in the October 2015 issue of JADA (vol. 146 issue 10, pp. 713-714) and written by Arthur H. Friedlander and et al. The article discusses the concept of shared decision making “…particularly necessary in dentistry at this juncture, given recommendations but inconclusive data available to support abandoning the provision of prophylactic antibiotics to patients with total joint prostheses.” I have previously talked about shared medical decision making in the blog post The Well Informed Patient http://blog.teethremoval.com/the-well-informed-patient/. The article talks about how historically patients were expected to consent to the recommendations of their doctors without much discussion. However, since this is not enough to be legally and ethically correct shared decision making can be used which is a “…collaborative process encouraging patients and their providers to make health care decisions together, taking into account the best scientific evidence available as well as the patient’s values and preferences.” The authors go on to state “This bioethical, patient-centered, informed consent process demonstrates respect for the patient’s autonomy and supports their empowerment at a time when illness renders them dependent and vulnerable. Furthermore, it enhances […]

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