Wisdom Teeth

Looking at the Concept of Prevention in Dentistry

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An interesting article written by Jay W. Friedman, DDS, MPH, appears in J Evid Base Dent Pract, vol. 12, pp. 53 – 54, 2012. In the article a discussion of three different types of prevention is made. primary prevention secondary prevention tertiary prevention Primary prevention is described as the well known prevention in which one attempts to not have any dental caries, not have any periodontal disease, and not have any loss of teeth. This form of prevention is when one regularly brushes their teeth, flosses, has a dental cleaning, and radiographs performed. The author discusses how typically dentists recommend 6 month intervals between examinations and cleanings. He then says “Patients who form minimal calculus and have no periodontal disease likewise do not need semiannual prophylaxis, or additional service…Lacking evidence of need, this is not prevention but rather FUN (functionally … Read more

Bupa Ends Covering Wisdom Teeth Extractions Deeming Them Unnecessary

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There is a lot of debate regarding removing asymptomatic third molars (wisdom teeth). Those who argue against removing asymptomatic wisdom teeth (retaining) are often accused of trying to save the insurance industry money (See for example Rogue Dentist’s Crusade), while those who argue for extracting asymptomatic wisdom teeth for preventative purposes are often accused of being interested in making more money due to the commonly used fee for service health care system. Somehow in the hoopla the patient’s health seems to take a back seat to some party making (or saving) money. Recently an article came out in London in the Times titled “Health insurer’s chief takes the knife to ‘unnecessary surgery” by Nic Fildes and Andrew Clark, March 13, 2013. The article opens by saying “Want to get your wisdom teeth extracted? Don’t ask Bupa, which is cutting back on … Read more

Systematic Review of Prophylactic Extraction of Third Molars: From Brazil

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Many reviews have been conducted in recent years to determine if healthy third molars (known as wisdom teeth) should be prophylacticly extracted as in removed before causing problems. A new study by Moacir Guilherme da Costa and four other researchers titled “Is there justification for prophylactic extraction of third molars? A systematic review,” appears in Braz Oral Res., (São Paulo) 2013 Mar-Apr;27(2):183-8. The article discusses how in the United States roughly 10 million wisdom teeth are extracted from around 5 million individuals each year. The article discuss how several reasons are usually given for extracting wisdom teeth pericoronitis periodontal defects in the distal region of the second molar caries in the third or second molars different types of odontogenic cysts and tumors crowding of the lower incisors indications for orthodontic, prosthetic or restorative purposes The authors state how the majority … Read more

The Correlation of Mandibular Incisor Crowding and Third Molars in Brazilians

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An article written by Lilian-Harumi Karasawa and 4 others titled ” Cross-sectional study of correlation between mandibular incisor crowding and third molars in young Brazilians,” appears in Med Oral Patol Oral Cir Bucal (currently in press the version I have looked at but was accepted in November 2012). The article sets out to examine the correlation between lower incisor crowding and the mandible third molar (lower wisdom tooth).  The ability of a lower wisdom tooth to have lower incisor crowding has been debated and looked at by many researchers over the years. See for example Review of the Wisdom Behind Third Molar Extractions. The possibility that a lower wisdom tooth can cause crowding is often given as a justification for removing a lower wisdom tooth to prevent abnormal orthodontic conditions. In this study the researchers took 300 healthy Brazilian young … Read more

Dental Anesthesia May Stop the Development of Wisdom Teeth

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An interesting study appears in the April 2013, JADA which looks at whether dentists giving inferior alveolar nerve blocks to young children may be stopping wisdom teeth from later developing. The article is titled “Inferior alveolar nerve block and third-molar agenesis: A retrospective clinical study,” and by Jerry Swee and et al., JADA, April 2013, vol. 144, issue 4, pp. 389-395. In the study the researchers looked at children who had received inferior alveolar nerve block (a local anesthesia) between the years of 2 and 6 at the Tufts dental clinic and also had a dental x-ray taken 3 years or after of being initially treated. The researchers arrived at 439 potential wisdom tooth sites from 220 patient records for their analysis. The control group consisted of 376 potential wisdom tooth sites where it was clear that the child never … Read more