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

Unsafe Injection Practices Plaque U.S. Outpatient Facilities

In a post last year I discussed how an Oral Surgeon Investigated for Reusing Needles and Syringes. In a recent article in JAMA titled “Unsafe Injection Practices Plague US Outpatient Facilities, Harm Patients,” Bridget M. Kuehn discusses many problems with injection practices (December 26, 2012,Vol 308, No. 24, pp. 2551-2552). She describes how hepatitis C virus was contracted by 2 patients who received an epidural injection from a pain management clinic. “During the visit, they observed the physician who treated both patients withdrawing medication from a multiple-dose vial with a previously used syringe topped with a new needle, a breach of safe injection practices that may have contaminated the vial and exposed subsequent patients to potential blood-borne infections.” This led to 8,000 patients who were treated at the clinic to be tested and 8 additional cases of hepatis C to … 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

Planning Intravenous Sedation for Wisdom Teeth Surgery

An article (in press at the time of writing this -2012) appears in the International Journal of Oral and Maxilofacial Surgery titled “Does planned intravenous sedation affect preoperative anxiety in patients?” by M. Seto, Y. Sakamoto, H. Takahashi, R. Kita, and T. Kikuta. The authors set out to evaluate The Spielberger’s State-Trait Anxiety Inventory (STAI) which can be used to evaluate levels of state and trait anxiety. State anxiety is defined as a subjective feeling of nervousness, whereas trait anxiety is defined as an individual’s underlying tendency to perceive a situation as stressful or threatening. One hundred and eleven (111) Japanese patients who were scheduled to have wisdom teeth extracted under local anesthesia were evaluated. STAI evaluates the degree anxiety based on 5 stages. The article states “The authors assessed preoperative anxiety using STAI at the initial visit and recommended … Read more

Videos Related to Oral and Maxillofacial Surgery

For those who are contemplating having oral and maxillofacial surgery or are in urgent need of health treatment they may want to consider viewing some educational videos. The American Association of Oral and Maxillofacial Surgeons (AAOMS) has recently uploaded many of their videos to their YouTube page over at http://www.youtube.com/user/aaomsvideo. They also have a Vimeo page that contains many of the same videos over at http://vimeo.com/aaoms/videos. I have previously commented on a video on Anesthesia in the Oral and Maxillofacial Surgeons Office. I was critical of the video as I pointed out in my prior blog post. A newer video on third molars (wisdom teeth) has been made available. This video is made in partnership with the American Association of Orthodontists.  The video describes how a wisdom tooth can be impacted and how surgery can be performed to remove a … Read more