Tag Archives | third molar

Differing Views in Medicine and Dentistry Applied to Wisdom Teeth

An interesting article appears in the 2014 version of the Journal of Oral and Maxillofacial Surgery titled “Asymptomatic Third Molars Under Nominalist and Essentialist Lenses,” written by V. Wallace McCarlie and Daniel L. Orr II, pp. 658-659.  The authors define two differente views: 1) essentialism and 2) nominalism and then try to apply them to the management of wisdom teeth. The authors state “Essentialism is the notion that underlying every properly defined disease is an unchanging reality causing illness. Conversely, nominalism is not concerned with underlying causes, but rather with signs and symptoms of illness.” In the article the authors mention a study which says that dentists detect rather than diagnose. The authors later say that detection implies nominalism and diagnosis implies essentialism. The authors give some downsides to both points of view. For example, they say essentialism is less focused on the patient and treatment. They say nominalism does not focus on causes which may be important for prevention. The authors state “An example of the importance of not focusing solely on symptoms (nominalism) is the case of asymptomatic impacted third molars. Life-threatening head and neck pathology, such as space infections, necrotizing fasciitis, osteomyelitis, and cysts or tumors, may […]

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Should the NICE Guidelines for Management of Wisdom Teeth (Third Molars) be Reevaulated?

An article titled “Changes in Demographics of Patients Undergoing Third Molar Surgery in a Hospital Setting Between 1994 and 2012 and the Influence of the National Institute for Health and Care Excellence Guidelines,” written by Vahe Petrosyan and Phillip Ameerally appears in the February 2014 issue of the Journal of Oral and Maxillofacial Surgery, pp. 254-258. The article discusses how National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) were published around 2000 recommending against prophylactic removal of wisdom teeth. This led to a reduction in surgeries performed. In the article the authors question whether or not the NICE guidelines on wisdom teeth should be updated. They mentioned a 2009 study which said 27% of previously symptom free wisdom teeth can become symptomatic after 1 year, especially those that are distoangularly impacted. In the article the authors looked at data from Northampton General Hospital in England which services around 0.7% of the population over the time period from 1994 to 2012. A total of 10,447 patients older than 16 years were treated during the study period. The mean patient age increased from 29 years in 1994 to 36 years in 2012, with the median […]

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The Costs of Third Molar (Wisdom Teeth) Management

I have previously commented on the costs associated with wisdom teeth in a 2013 blog post that was based on a 2012 article appearing in the Journal of Oral and Maxillofacial Surgery (see http://blog.teethremoval.com/the-costs-associated-with-third-molars-wisdom-teeth/). More recently, another article discussing the costs of wisdom teeth has appeared in the 2014 Journal of Oral and Maxillofacial Surgery titled “The Cost of Third Molar Management” written by Gino Inverso, Ronald Heard, and Bonnie L. Padwa (issue 72, pp. 1038-1039). This article takes the position that most previous studies focused on discussing wisdom teeth costs when taking the position from the cost of billing to private insurance companies. Their article attempts to use the true cost which they feel should help promote discussion of the topic of retaining or removing healthy disease free wisdom teeth and possibly increase access to care. In their analysis they determine the approximate time spent with an oral surgeon and their staff for a patient for a consultation, an operative visit, and a post-operative visit. They then determine the estimate annual cost associated with an oral surgeon, a surgery assistant, and a receptionist in a private oral and maxillofacial surgeon office in 2013. This total cost for all 3 comes in at […]

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When Abstinence is Evidence-Based

I came across a 2012 talk Jay W. Friedman gave titled “When Abstinence is Evidence-Based: The Case Against Prophylactic Third Molar Extractions,” at the 2012 National Oral Health Conference. The PowerPoint for the talk is located over at http://www.nationaloralhealthconference.com/docs/presentations/2012/05-02/Jay%20Friedman.pdf (I have mirrored it over at http://www.teethremoval.com/When_abstinence_is_evidenced_based.pdf). For those not aware of Jay W. Friedman you can start by reading the post American Journal of Public Health Author Jay W. Friedman is 2009 Author of the Year and Looking at the Concept of Prevention in Dentistry. Some interesting graphics appear in the talk, a few which I have included in this post. The talk is very concise and to the point and very informative for anyone considering whether or not to extract wisdom teeth (third molars). I will now provide a brief overview of the talk, but encourage you to look at the full talk yourself. Like usual (see http://www.teethremoval.com/controversy.html) several jabs are taken at AAOMS (the American Association of Oral and Maxillofacial Surgeons). For instance, he mentions how AAOMS placed a 4 page ad in USA Today in 2007 and didn’t mention any potential complications from extraction. He says that even though AAOMS has changed the language on their website […]

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Removing Wisdom Teeth May Improve The Periodontal Health of Remaining Teeth

An interesting article titled “Removal of Symptomatic Third Molars May Improve Periodontal Status of Remaining Dentition,” by Carolyn Dicus-Brookes and et al. appears in the Journal of Oral and Maxillofacial Surgery (vol. 71, pp. 1639-1646, 2013). The article seeks to explore the impact of removing wisdom teeth on the periodontal status of adjacent second molars and other teeth located in the mouth specifically for patients who have mild symptoms of pericoronitis. As discussed recently over at Upcoming Changes to JOMS and AAOMS in 2014, select articles in JOMS will have press releases written by AAOMS staff to accompany them. This is one of those articles so that feature appears to have already been rolled out. To get an idea of what the press release entails I will briefly describe it. It is very short (less than 10 sentences) and fits on 1 page. It was released on October 1, 2013. The press release states 69 patients were followed with mild symptoms of pericoronitis. All patients had wisdom teeth prior to the study start and had an average age of 21. The main conclusion of the study as stated in the press release, is that at the beginning of the study […]

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