Tag Archives | Wisdom Teeth

Using Fibrin Glue to Help Lingual Nerve Repair

An interesting article titled “Use of Fibrin Glue as an Adjunct in the Repair of Lingual Nerve Injury: Case Report,” was written by Nicholas P. Theberge and Vincent B. Ziccardi and appears in the 2016 Journal of Oral and Maxilofacial Surgery (vol. 74, pp. 1899 e1-e4). The article describes a report of a case of a woman in her 20s who had an impacted wisdom tooth removed and developed left lingual nerve numbness and pain. She later had surgery with fibrin glue to help correct the lingual nerve injury. The article reports that most lingual nerve injuries after wisdom teeth removal occurs in 0.4% to 22% of cases. Such an injury can be detrimental to patients and lead to drooling, tongue biting, self-induced thermal injuries, and changes in speech, swallowing, and taste perception. Lingual nerve deficit has been reported to have the highest incidence in distally impacted lower wisdom teeth, followed by horizontal, mesial, and vertical impactions. When an injury to the lingual nerve occurs full recovery occurs in most patients (58%) within the first 6 months and in 72% patients after 2 years. The article later describes the specific surgery done on the woman. The nerve was freed with […]

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Treating with Platelet Rich Fibrin After Wisdom Teeth Removal

An interesting article titled “Evaluation of Treatment Outcome After Impacted Mandibular Third Molar Surgery With the Use of Autologous Platelet-Rich Fibrin: A Randomized Controlled Clinical Study,” appears in the Journal of Oral and Maxilofacial Surgery written by Nilima Kumar and et al. (vol 73, pp. 1042-1049). The article sets out to explore the effect of platelet-rich fibrin (PRF) on postoperative pain, swelling, trismus, periodontal healing near the second molar, and progress of bone regeneration in upper wisdom teeth extraction sockets. Clinicians have identified a subpopulation of patients having wisdom teeth removed that are at ‘‘high risk’’ for periodontal defects after wisdom teeth removal (such as greater than 26 years old, pre-existing periodontal defects [attachment level, >3 mm; probing depth, >5 mm]; and horizontal or mesioangular impaction). The authors studied a patient sample that consisted of 31 patients with mesioangular or horizontal upper impacted wisdom teeth. Patients in the study were randomized by the closed-envelope method and divided into 2 groups. In one group, 16 patients had a impacted mandibular wisdom tooth surgically removed and PRF was placed into the extraction socket followed by flap approximation. The control group  had 15 patients treated with surgical removal of the impacted mandibular wisdom […]

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Filing Billing for Dentists to Help Patients

An interesting article titled “You want me to do what?” written by Douglas Auld appears in the March 2016 issue of JADA. The article discusses a patient who has an an abscess on a mandibular right third molar which requires extraction. The treatment was done in December and the patient had already used their full benefits from their dental insurance for the year. So the patient suggested to the dentist to bill for the extraction in January and also suggested to file it as a surgical extraction and apply the difference to his balance. The article asks if it is ethical for dentists to do any of this. The article states that a dentist has a duty to communicate truthfully with third parties. It says “A dentist who submits a claim form to a third party reporting incorrect treatment dates for the purpose of assisting a patient in obtaining benefits under a dental plan, which benefits would otherwise be disallowed, is engaged in making an unethical, false or misleading representation to such third party.” Therefore the dentist should file the claim with the correct date of service or wait until January to perform the treatment. The article says “A dentist who incorrectly describes on […]

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Wisdom Teeth Facts – From Symptoms & Occurrence to Extractions & Precautions

What are Third Molars? A permanent dentition typically consists of 32 teeth and third molars or wisdom teeth are the most posterior teeth present on each quadrant. They are located the farthest in a dental arch and are usually the last ones to erupt. The third molars are formed due to evolutionary factors but with modern lifestyle and eating habits, they are no longer necessary. This is why smaller jaws have inadequate space to accommodate the eruption of third molars and all they do is cause pain, infection and discomfort. When Do Wisdom Teeth Erupt & Why? Wisdom teeth usually erupt between the ages of 16 to 25 but they may also erupt at a later stage for some. According to popular belief, wisdom teeth were used by ancestors for grinding plant tissues. Since our ancestors had a huge mouth which accommodated more teeth for digesting cellulose, third molars became a part of the tooth development process. This is why most of the time wisdom teeth either remain submerged under the gum or erupt only partially. Indications of Extraction If the jaw is large enough to accommodate the eruption of third molars and if they are aligned correctly, an extraction […]

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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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