The Defensive Patients Guide to Wisdom Teeth Removal

Medical doctors are often accused of practicing what is known as defensive medicine. With defensive medicine, a doctor will deviate from the normal practice of medicine in order to perform a medical treatment or run a diagnostic test in order to reduce potential exposure to a malpractice lawsuit. This leads to treatments and tests that are not clinically necessary and is often said to be a cause of overtesting and overtreatment. Defensive medicine is discussed as serving to protect the physician from a lawsuit by the patient. What is not discussed is the idea that a patient can also practice defensive medicine to protect the patient from losing a legitimate lawsuit against the physician. Applying this concept to wisdom teeth surgery, the following is suggested for a patient to help protect themselves from losing a legitimate lawsuit against a physician, … Read more

Opioid Prescriptions From Dental Clinicians for Young Adults and Subsequent Opioid Use and Abuse

A very interesting article titled “Association of Opioid Prescriptions From Dental Clinicians for US Adolescents and Young Adults With Subsequent Opioid Use and Abuse” written by Schroeder et al. was published online on December 3, 2018, in JAMA Internal Medicine. The article sought out to examine the association between dental opioid prescriptions from dental clinicians for adolescents and young adults and new persistent use and subsequent diagnoses of abuse. The article states that dentists are the leading source of opioid prescriptionsfor children and adolescents from age 10 to 19 and in 2009 prescribed 31% of total opioids given to this age group. A common source of dental opioid exposure is of course wisdom teeth extractions. The article states that the authors were at least partially motivated to perform their study over the controversy surrounding whether or not one should extract or retain healthy wisdom … Read more

An Australian perspective of removing or retaining wisdom teeth (third molars)

An article titled “Cost effectiveness modelling of a ‘watchful monitoring strategy’ for impacted third molars vs prophylactic removal under GA: an Australian perspective” appeared in the July 2015, British Dental Journal and written by A.A. Anjrini, E. Kruger, and M. Tennant (issue 219, pp. 19-23). The article discusses the direct and indirect costs associated with removing impacted wisdom teeth in Australia. A news article appearing on the Australian ABC Science (http://www.abc.net.au/science/articles/2015/08/17/4283895.htm) titled “Wisdom teeth: are we removing them more often than needed?” by Anna Salleh and written on August 17, 2015, discusses some of the points made in the journal article. The authors were interested in determining if a watchful waiting monitoring strategy should be used for impacted wisdom teeth or if a prophylactic strategy should be used. They looked at hospitalization data for impacted wisdom teeth removal for 2008 … Read more

Is Not Removing Wisdom Teeth Causing Harm?

An interesting article titled “Is official advice about NOT pulling out wisdom teeth doing more harm than good?” appeared earlier this year in February 2015, on the DailyMail over at http://www.dailymail.co.uk/health/article-2946498/Is-NHS-causing-agony-telling-dentists-not-pull-wisdom-teeth.html and written by Cara Lee. The article questions whether or not the year 2000 guidelines from the National Institute for Health and Care Excellence (NICE) went too far with preventing wisdom teeth extractions in teenagers and young adults. In these guidelines NICE said that the practice of prophylactic removal of pathology-free impacted third molars should be discontinued in the National Health Service in the U.K. Hence only wisdom teeth with problems should be extracted. In the article on the DailyMail there is a discussion of a 31 year old male who never had wisdom teeth extracted in his teens. Now he needs his wisdom teeth extracted and the molars … Read more

A Study of Outcomes Related to Wisdom Teeth Removal

An interesting article titled “A Prospective Study of Clinical Outcomes Related to Third Molar Removal or Retention,” appears in the American Journal of Public Health (April 2014, Vol 104, No. 4) written by Greg J. Huang and et al. The article is a companion article to another also on wisdom teeth in the April 2014 issue of the journal. I discussed the companion article last week in the blog post http://blog.teethremoval.com/practice-based-wisdom-teeth-removal-study/. The article opens by mentioning the controversy surrounding the removal of wisdom teeth. On one side some have advocated for wisdom teeth to be removed to prevent future pathology and minimize risks, others have advocated for wisdom teeth to be removed to prevent lower incisor crowding, and others have argued for wisdom teeth to be removed to prevent periodontal pathology. On the other side some have advocated for wisdom … Read more