Tag Archives | oral surgery

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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Can Playing Baseball in Youth Lead to Better Surgeons?

An interesting article by Thomas Dodson titled “Everything I Ever Needed to Know About Oral and Maxillofacial Surgery, I Learned Playing Baseball” appears in the 2016 Journal of Oral and Maxillofacial Surgery (vol. 74, pp. 1709-1710). In the article the author tries to tie in how the game of baseball can teach oral and maxillofacial surgeons much of what they need to know. The author opens by talking about how he is saddened by the lost of Dr. William Harrison Bell who was a prominent surgeon in the field. He then explains that himself and the doctor who passed were both very big into baseball as youths. Dr. Dodson played first base in college and Dr. Bell was a minor league player. Dr. Dodson said that all the doctors he has worked with at various institutions all have been enthusiastic about baseball. He wonders if there is something that causes oral and maxillofacial to like baseball. The author says “While baseball may seem to the unindoctrinated to be a bunch of players randomly chasing a ball, in fact, the flight of a hit is remarkably predictable based on the type of pitch being thrown. Fielders know exactly where to stand and how to execute a double-play with reflexive precision.” He […]

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How Effective is Antimicrobial Prophylaxis in Oral Procedures

An interesting article titled “Effectiveness of Antimicrobial Prophylaxis in Preventing the Spread of Infection as a Result of Oral Procedures: A Systematic Review and Meta-Analysis” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by J. A. Moreno-Drada and H. A. Garcia-Perdomo (vol. 74, pp. 1313-1321). The article seeks to explore the effectiveness of prophylactic antibiotics (such as amoxicillin) for preventing localized infections of the oral cavity, neck, and thoracic cavity in patients undergoing oral procedures. Bacteremia is well known to occur after dental procedures. Severe complications as a result of infections from bacteremia have been reported. Based on expert opinions, it has been recommended that prophylaxis be given to patients at high risk before manipulation of the gingiva or periapical region of the teeth and before perforation of the oral mucosa during dental procedures. However the use of prophylactic antibiotics is controversial. In some cases this could lead to antiobiotic resistance. In the face of bacterial resistance, infections can continue to disseminate through the anatomic planes and pathways with lower resistance, leading to complications, such as Ludwig angina, thoracic empyema, septicemia, necrotizing fasciitis, cavernous sinus thrombosis, mediastinal retinitis, cerebral abscess, meningitis, and bacterial endocarditis. The study explored articles with women and men older than 18 years who underwent oral procedures and received a prophylactic antibiotic (single preoperative dose) or another intervention for the prevention of […]

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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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Can you Use Low Level Laser Therapy After Wisdom Teeth Removal to Reduce Pain?

An interesting article titled “Is Low-Level Laser Therapy Effective in the Management of Pain and Swelling After Mandibular Third Molar Surgery?” appears in the July, 2016, issue of Journal of Oral and Maxillofacial Surgery and written by Majid Eshghpour, Farzaneh Ahrari, and Mohammad Takallu. The article seeks to explore if using low-level laser therapy after removing impacted wisdom teeth can reduce pain and swelling. In the study 40 patients included had lower impacted wisdom teeth on both sides. One side was subjected to lower level laser therapy and the other side just placebo. After removing wisdom teeth patients often experience pain, swelling, and tristmus for several days. Pain usually reaches a peak 3 to 5 hours after surgery while swelling peaks around 12 to 48 hours later. The trauma that occurs during surgery leads to inflammation which causes these other symptoms. Surgeons typically prescribe medications to help alleviate these concerns but these have side effects. Treatments like low level laser therapy are believed to be without side effects. The study took place in Iran and to be included the patients had to have lower wisdom teeth on each side similar in position and inclination. Patients with certain diseases were excluded from the study. It […]

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