teeth extraction

Dentist suspended after patient died after teeth extraction

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A dentist in the state of Washington has had their dentistry license suspended over allegations of unsafe practices after a patient died while having multiple teeth removed in 2022. The patient had a significant medical history and was having teeth extracted in June 2022 in advance of a scheduled heart valve surgery. The patient was under moderate sedation for abot five minutes before a drop in oxygen-saturation level, heart rate and blood pressure. The patient had hypertensive cardiovascular disease, valvular heart disease, congestive heart failure, pulmonary emphysema, chronic disease, diabetes, and obesity. In advance of the extractions the dentist had received medical clearance from the patient’s primary care provider but the dentist had not talked to any other doctors treating the patient. During the day of the extractions, the patient was given articaine, lidocaine, triazolam, midazolam, decadron, and cefazolin. Roughly … Read more

Nonsteroidal anti-inflammatory drugs better than opioids for pain after dental extractions

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An interesting article titled “Acute Postoperative Pain Due to Dental Extraction in the Adult Population: A Systematic Review and Network Meta-analysis,” written by A. Miroshnychenko and et. al appears in the 2023 edition of the Journal of Dental Research. The article seeks to conduct a systematic review and meta-analysis to assess tto compare the effectiveness of 10 different pharmacological treatments including acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and opioids, to the management of acute pain after dental tooth extractions. Further the article looked at the pain associated with pulpitis or its complications. The authors were motived to conduct the review based on the opioid crisis occuring in North America which has been discussed before on this site, see for example the posts Assessing the Impact of Three Day Opioids Limits for Dentists, Dentists Overprescribing Opioids to Adults in the U.S., and Reducing … Read more

Patient Stress Impact on Tooth Extraction Complications

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An interesting article titled “The potential role of patient stress in rates of dental post-extraction complication” written by McDowall appears in the 2014 edition of Oral Surgery (vol. 7, pp. 162-167). The article explores whether stress, alcohol and tobacco use impacts the complication rate experienced after a tooth extraction. The authors recruited patients for the study who were at least 16 years old and having at least one tooth extracted. The patients were asked to fill out questionnaires incorporating the Global Measure of Perceived Stress Scale (PSS), the Fast Alcohol Screening Test (FAST) and questions related to tobacco use. The PSS consists of fourteen questions designed to determine how stressful the persons life is and higher scores indicated greater perceived stress. The FAST consists of four questions designed to determine the frequency too much alcohol consumption and higher scores indicate … Read more

Illinois Man Dies From Too Much Anesthesia While Having Teeth Extracted

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A 51 year old man from Illinois died after having five teeth extacted in July 2021. He had has teeth extracted by an oral surgeon in Lake County which is North of Chicago. During the procedure he was given as given a single dose of 200 milligrams propofol. There was no anesthesiologist present and the oral surgeon was the one also administrating the anesthesia. During the tooth extractions, the man stopped breathing and went into cardiac arrest. Emergency responders were called and when they arrived took the man to a hospital where he died the next day. According to statements from the Lake County Coroner there was too high of a dose of propofol given and this dose would cause a person to not breathe. Further, the oral surgeon did not supply supplemental oxygen until the tooth extractions were already … Read more

FDA warns about dental problems from buprenorphine

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The U.S. Food and Drug Administration (FDA) has issued a safety concern regarding the medication buprenorphine which is a medication used to treat opioid use disorder, acute pain, and chronic pain. Buprenorphine is often used to reduce opioid withdrawal symptoms and the desire to use opioids, without causing the cycle of highs and lows associated with abusing opioid. The FDA warning issued on January 12, 2022, states that dental problems have occured when patients take medicines containing buprenorphine that are dissolved in the mouth. In the warning, the FDA said that the dental problems can include those of tooth decay, cavities, loss of teeth, and oral infections, and can occur in those without prior dental issues. As a result of this warning, the risk of dental problems occuring will be added to the prescribing information and the patient Medication Guide … Read more