Tag Archives | wisdom teeth surgery

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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Does Midazolam Impact the Recovery Room Stay for Wisdom Teeth Surgery?

An interesting article titled “Does Intravenous Midazolam Dose Influence the Duration of Recovery Room Stay Following Outpatient Third Molar Surgery?” appears in the 2015 Journal of Oral and Maxilofacial Surgery written by Kyle S. Ettinger and et al. (vol. 73, pp. 2287-2293). Midazolam is very commonly used for patients undergoing wisdom teeth surgery and the authors set out to determine if it impacts the length a patient stays in the recovery room. Intravenous (IV) midazolam has a rapid onset of effect, short duration of action, minimal impact on cardiac function, minimal effect on respiratory depression, and it produces anterograde amnesia. Some more recent literate has shown that IV midazolam might be associated with prolonged recovery time for oral surgery. Midazolam can cause postoperative cognitive impairment. The study used patients who had all four wisdom teeth removed at the Mayo Clinic in Rochester Minnesota between the ages of 14 and 29. The primary predictor variable for the study was the total dose of IV midazolam administered. The primary outcome variable was the duration of recovery room length of stay (LOS) documented in the electronic anesthesia record. A total of 2,610 patients were eventually included in this retrospective study. The mean dosage of midazolam administered was 4.1 mg (SD, 1.1 mg; range, 0.5 to 10.0 mg). The […]

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Exploring Antibiotic Use with Lower Wisdom Teeth Surgery

An interesting article titled “Correlation of antibiotic prophylaxis and difficulty of extraction with post operative inflammatory complications in the lower third molar surgery” appears in the 2014 British Journal of Oral and Maxillofacial Surgery and written by J. Y. Lee and et al. (vol. 52, pp. 54-57). The article set out to investigate the correlation between antibiotic prophylaxis, difficulty of extraction, and postoperative complications of lower wisdom teeth. The authors say that indiscriminate antibiotic prophylaxis can lead to antimicrobial resistance and a shift in the microbial population. The authors performed a retrospective analysis of extraction of lower wisdom teeth performed at Korea University Guro Hospital over a two year time frame starting in January 2010. The authors only included cases in which cefditoren pivoxil was prescribed as an antibiotic. In addition, patients that were kept in a hospital due to postoperative complications were excluded from the study. The patients were divided into two groups those given antibiotics and those not given antibiotics. A total of 1222 extractions in 890 patients were included in the study. The authors found that overall the difficulty of extraction and post operative complications were significantly associated (p=0.03). In cases grouped by similar class of difficulty, it was found that there was no significant correlation […]

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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 next to his wisdom teeth possibly extracted due to decay and cavities. There is also a discussion of a 24 year old female who never had her wisdom teeth extracted in her teens. Now she has been experiencing intense intermittent pain in her lower jaw. Sometimes she had difficulty eating and the pain woke her up from sleeping. This will […]

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Seventeen Year Old Minnesota Teen Dies After Wisdom Teeth Extraction

A few weeks ago in June, 2015, a 17 year old Minnesota woman died about a week after having wisdom teeth surgery. Near the end of the wisdom teeth surgery her blood pressure increased, her pulse dropped, and she went into cardiac arrest. She then was transferred to a hospital and suffered from seizures and swelling in her brain until passing about a week later. It is not clear what caused the death to occur. She could have possibly had an undisclosed heart condition that has occurred in other cases. It is possible for a patient to only become aware of an asymptomatic and abnormal heart rhythm once they come in for a surgery. I have discussed other deaths from wisdom teeth removal on this website (see http://www.teethremoval.com/death.html). Based on numerous studies and publications I have said that around 1 death occurs in every 400,000 from wisdom teeth surgery (see http://www.teethremoval.com/mortality_rates_in_dentistry.html). For some additional cases where a teenager died after wisdom teeth surgery in the United States of America see for example http://blog.teethremoval.com/flesh-eating-bacteria-leads-to-death-after-wisdom-teeth-removal/ and http://blog.teethremoval.com/wisdom-teeth-removal-leaves-to-death-two-days-after/. Source: Elizabeth Narins. 17-Year-Old Girl Dies After Getting Her Wisdom Teeth Removed. June 16, 2015. http://www.cosmopolitan.com/health-fitness/news/a41983/17-year-old-girl-dies-after-getting-her-wisdom-teeth-removed/. Accessed July 4, 2015.

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