Month: July 2019

Profit Motives in Oral and Maxillofacial Surgery Utilizing Sedation

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Recently on this site it was discussed how guidelines have come out from the American Academy of Pediatric Dentistry (AAPD) and American Academy of Pediatrics (AAP) recommending when deep sedation or general anesthesia is given to children in dental offices there should be two trained individuals present. One individual should provide the dentistry and the other individual is responsible to administer the sedation or anesthesia and to observe the patient for any adverse events. This goes against the single provider model that has been advocated by the American Association of Oral and Maxillofacial Surgeons (AAOMS) and is typically utilized for wisdom teeth removal in the United States of America, where the oral surgeon performs both the dentistry and the administration of sedation or anesthesia. Some have criticized the AAOMS position of a single provider model for its focus on profit … Read more

Delivering Cognitive-Behavioral Treatment in Dental Practices

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An interesting article titled “Dentist-Perceived Barriers and Attractors to Cognitive-Behavioral Treatment Provided by Mental Health Providers in Dental Practices,” written by Heyman et al. appears in Advances in Dental Research (vol. 29, no. 1, pp. 35-41, February 2018). The article discusses how over 20% of dental patients report having dental fear and how over 20 randomized controlled trials have show that Cognitive-Behavioral Treatment (CBT) can help. Even though such CBT treatment has been shown to help it has not been widely used beyond dental fear specialty clinics according to the authors. The authors feel that the treatment is recognized but the way to disseminate it throughout the US health care system is needed. The authors explore enhancing the dental home via an approach known as evidence-based collaborative care where specialized mental health providers work within the dental home to provide … Read more

Risks of Keeping Wisdom Teeth: Infected Wisdom Tooth Removal Leads to Sepsis

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Recently a case of a 25 year old woman from England who developed an infected wisdom tooth has been reported. The woman had the infected wisdom tooth removed in December 2018 after repeated infections had developed. Unfortunately the surgery was eventful and the woman developed complications. Two days after the extraction the woman was not able to hold down any food nor any water. She was urged to go to a hospital by a doctor and spent four days at a hospital. While at the hospital she went into septic shock and was diagnosed with sepsis. She was given intravenous antibiotics and liquids. It was believed that when the wisdom tooth was removed the infection that was present went into her bloodstream. When she was released from the hospital the woman was given six different medications to take. Roughly six … Read more

Updated Sedation Guidelines in Dentistry for Children

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Recently new guidelines have been issued regarding the use of sedation for dental procedures performed on children. In the past on this site some scrutiny has been placed on sedation provided to children during dental procedures because of many deaths that have occurred, see for example What to Ask the Dentist Before Children Have Sedation and Pediatric Dental Death in Cambridge, Ontario, Canada Spurs Comments on Dental Anesthesia. In the June 2019 edition (vol. 143, no. 6) of Pediatrics in an article titled Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures written by Coté and Wilson updated guidelines for the use of sedation in dentistry is provided. These guidelines were updated for the American Academy of Pediatric Dentistry (AAPD) and American Academy of Pediatrics (AAP) for the first time in … Read more