Tag Archives | wisdom teeth extraction

Avoiding Amoxicillin During Wisdom Teeth: What are the Possible Problems

An interesting article titled “Dental Care Professionals Should Avoid the Administration of Amoxicillin in Healthy Patients During Third Molar Surgery: Is Antibiotic Resistence the Only Problem?” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Othoniel H. Aragon-Martinez and et al. (vol. 74, pp. 1512-1513). The authors attempt to explain why amoxicillin should not be used during wisdom teeth surgery. Amoxicillin is commonly used to prevent infections. Information from high quality clinical trials has shown that amoxicillin is not effective to reduce the risk of wound infections when it is received both preoperatively and postoperatively.  Recent evidence has shown that the administration of 250 mg of amoxicillin in healthy volunteers every 8 hours for 7 days produces  antibiotic resistance. The authors also discuss the topic of dysbiosis. Dysbiosis is a detrimental modification in the composition of the microbiome alongside altered microflora functions, which can be produced by antibiotic exposure, type of diet, lifestyle habits, and other factors. Amoxicillin causes marked alterations in fecal microbiota during the treatment course. Dysbiosis in can produce harmful changes in health, including the accumulation of antimicrobial resistances, increased susceptibility to infectious diseases, altered immune homeostasis, and deregulated metabolism. This could contribute to a delayed onset of local infection of wisdom tooth extraction. The author states “The present information suggests that intestinal and oral […]

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Are There Differences in Complications After Wisdom Teeth Surgery Depending on the Sedation Received?

An interesting article titled “Complications of Moderate Sedation Versus Deep Sedation/General Anesthesia for Adolescent Patients Undergoing Third Molar Extraction” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Gino Inverso and et al. (vol. 74, pp. 474-479).  The authors set out to determine if there is any difference in complications occurring after wisdom teeth surgery when patients are given either moderate sedation or deep sedation. For patients undergoing wisdom teeth surgery they may have some say in what level of sedation they receive and it may also be based on the desires of the surgeon. Specifically the authors examined the complications resulting from moderate sedation versus deep sedation/general anesthesia for adolescent patients undergoing wisdom teeth extraction. They sought to determine if any differences in complication risk exist between the two levels of sedation. The authors explored a database commissioned by the the American Association of Oral and Maxillofacial Surgeons (AAOMS) which is known as the Oral and Maxillofacial Surgery Outcomes System (OMSOS). A total of 79 surgeons in 58 sites across the 6 AAOMS districts participated in the data collection. The patients had data entered into the OMSOS from January 2001 to December 2010. The patients included in the present study had to be less than or equal to 21 and had wisdom teeth extracted in an ambulatory […]

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Using Dexmedetomidine For Wisdom Teeth Surgery

An interesting article titled “Sedation Protocol Using Dexmedetomidine for Third Molar Extraction” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Dae-Seung Ryu and et. al. (vol. 74, pp. 926.e1-926.e7). The article seems to determine a sedation protocol for dexmedetomidine. The authors state that IV sedation is often given in cases of wisdom teeth surgery with midazolam being a medication commonly used. When midazolam is combined with opioids it can cause respiratory depression. Dexmedetomidine is an alpa2-agonist acting on adrenoceptors in many tissues, including those in the nervous, cardiovascular, and respiratory systems. Compared with midazolam, the major advantage of dexmedetomidine is its minimal effect on the respiratory system. It also produces an analgesic effect which can help alleviate the sensation of pain after tooth extraction. The authors set out to study the pain, patient satisfaction, sedation depth, and adverse effects after wisdom teeth extraction using dexmedetomidine and to compare IV and intranasal (IN) routes of administration. The patients included in the study were in Seoul Korea. They  were required to have ipsilateral upper and lower third molars. The upper molar had to be a routine extraction and the lower molar had to be a surgical extraction. A total of 240 patients were randomly assigned to one of three groups. In group 1 wisdom teeth extractions were performed under local anesthesia only. In group 2 […]

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Can Science Solve Our Problems?

An interesting article titled “Science and Conscience” appears in the 2015 Journal of Oral and Maxilofacial Surgery written by Thomas Dodson (vol. 73, pp. 2255-2256). The article opens by discussing a study by the NIH seeking to explore the differences in people with a systolic blood pressure of 140 mm Hg versus that of 120 mm Hg. The study was aborted with a year left in its duration. The study concluded achieving a target systolic blood pressure of 120 mm Hg reduced cardiovascular events by almost 33% and death by almost 25% compared with a group with a target systolic pressure of 140 mm Hg. The authors question why such a study was ever needed to be done because it seems so intuitive but later explains that our society today relies on science to achieve it’s high standards. The author then goes on to discuss how there is a growing anti vaccination movement to not give kids the vaccines against diseases like measles, mumps, and whooping cough. He then goes on to discuss how there is also a movement to no longer fluoridate the water in communities. He states that cavities can help be minimized by adding a small amount of fluoride to drinking water. In both […]

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Management of Wisdom Teeth 2016 AAOMS Updates

The American Association of Oral and Maxilofacial Surgeons (AAOMS) has some additional information they appear to have added more recently to their third molar research news section. For those considering how to best manage their wisdom teeth they should take a look at http://www.aaoms.org/docs/govt_affairs/advocacy_white_papers/management_third_molar_white_paper.pdf and http://www.aaoms.org/images/uploads/pdfs/management_third_molar_supporting_information.pdf. The first document describes what many different oral surgeons groups including AAOMS currently suggest for managing wisdom teeth. The article says “There are a variety of recognized management choices for third molars, including removal, partial removal (coronectomy), retention with active clinical and radiographic surveillance, surgical exposure, tooth repositioning, transplantation, surgical periodontics, and marsupialization of associated soft tissue pathology with observation and possible secondary treatment.” The article says that a decision to remove or retain healthy asymptomatic wisdom teeth should be made before a patient is 30. The position statement is said “Predicated on the best evidence-based data, third molar teeth that are associated with disease, or are at high risk of developing disease, should be surgically managed. In the absence of disease or significant risk of disease, active clinical and radiographic surveillance is indicated.” When wisdom teeth have no disease and no symptoms the surgeon should review the likelihood of pathology developing in the […]

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