Bleeding After Dental Extractions in Patients on Warfarin

An interesting article titled “Postoperative Bleeding Following Dental Extractions in Patients Anticoagulated With Warfarin” written by Anthony Febbo and et al. appears in the 2016 Journal or Oral and Maxilofacial Surgery (vol. 74, pp. 1518-1523). The article sought to explore the risk of bleeding in patients on warfarin after dental extraction. Warfarin is the most common anticoagulant used in Australia which can be used to prevent life-threatening thromboembolic events, such as stroke and deep vein thrombosis from occuring in patients at risk. Varying viewing points exisist as how to best handle these patients when a tooth or teeth need to be extracted. Some options include stopping the anticoagulant before extraction or continuing to use it while local hemostatic techniques are used. However ceasing the anticoagulant could be deadly so it is not generally used. The therapeutic effect of warfarin is … Read more

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 … Read more

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 … Read more

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 … Read more

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 … Read more