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 … Read more

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 … Read more

What is the Prevalence of Patients with Asymptomatic, Disease-Free Third Molars (Wisdom Teeth)

An interesting article titled “How Many Patients Have Third Molars and How Many Have One or More Asymptomatic, Disease-Free Third Molars?” appears in the September 2012, supplement 1. (vol. 70, issue 9) of the Journal of Oral and Maxillofacial Surgery written by Thomas B. Dodson, DMD, MPH (pg. S4-S7). The article seems to attempt to arrive at an answer to the question of how many patients really have a wisdom tooth (third molar) that is not causing problems and that has no disease. In the article Dr. Dodson recommends that patients are divided into 4 different categories when having their wisdom teeth evaluated. symptomatic, disease present (based on history and radiological examination) symptomatic, disease absent (includes teething and vague pain symptoms unrelated to wisdom tooth) asymptomatic, disease present (disease is evident from radiological findings or clinical exam but not patient … 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

Association Between Partially Erupted Mandibular Third Molar and Caries in Distal Second Molar

An interesting article titled “Association between the presence of a partially erupted mandibular third molar and the existence of caries in the distal of the second molars,” appears in the International Journal of Oral and Maxilofacial Surgery by S. G. M. Falci and et. al. (October 2012, pp. 1270-1274). The article mentions how previous studies have shown that caries on the mandibular second molar due to the presence of partially erupted third molars has varied between 7% and 32%. The article criticizes prior work where studies based their prevalence data on panoramic radiographs which is not as good as periapical radiographs when diagnosing caries. The authors state “The lack of sample characterization, the absence of sample calculation, the deficient or inadequate statistical analysis and the absence of a description of the eligibility criteria, discredits the scientific evidence of these previous … Read more