Wisdom Teeth

Nonsteroidal anti-inflammatory drugs better than opioids for pain after dental extractions

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An interesting article titled “Acute Postoperative Pain Due to Dental Extraction in the Adult Population: A Systematic Review and Network Meta-analysis,” written by A. Miroshnychenko and et. al appears in the 2023 edition of the Journal of Dental Research. The article seeks to conduct a systematic review and meta-analysis to assess tto compare the effectiveness of 10 different pharmacological treatments including acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and opioids, to the management of acute pain after dental tooth extractions. Further the article looked at the pain associated with pulpitis or its complications. The authors were motived to conduct the review based on the opioid crisis occuring in North America which has been discussed before on this site, see for example the posts Assessing the Impact of Three Day Opioids Limits for Dentists, Dentists Overprescribing Opioids to Adults in the U.S., and Reducing … Read more

Using an Eye Massager to Control Anxiety Before Wisdom Tooth Extraction

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An interesting article titled “Massage Therapy to Control Anxiety Before Extraction of an Impacted Tooth,” appears in Cureus in October 4, 2022, written by Kunusoth R, Colvenkar S, Alwala A, et al. (vol. 14, no. 10, pp. 29893). The article discusses a simple technique to manage anxiety during dental visits using an eye massager. Many patients experience anxiety when seeing a dentist, see for example the posts Changes in Dental Anxiety over Time and Dental Anxiety and Fear: Impact on Oral Health. Dental anxiety can be caused by such things as a prior past negative dental experience, fear of needles, and a fear of gagging or choking. These patients are more likely to cancel their appointments and may be more difficult to treat. Various treatment options for dental anxiety exist such as described in the posts Do Wisdom Teeth Surgery … Read more

What is the norcebo effect and does it matter for dentistry?

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An interesting article titled “What is the nocebo effect and does it apply to dentistry? A narrative review” written by T. Watanabe and et al. appears in the Journal of Oral Rehabilitation (2022). The article discusses the concept of a nocebo which is different than a placebo. A nocebo is where negative expectations lead to the effect of either clinical worsening, suboptimal treatment efficacy, or the occurrence of adverse events. A placebo on the other hand is where postive expectations leads to an effect that causes an improvement in symptoms. In the article the authors sought to explore the norcebo effect in dentistry which they say to date has been given very little attention which only a limited number of articles discussing it. The norcebo effect is real and has been demonstrated in numerous experimental and clinical settings, which hows … Read more

What Dentists Should Say to Patients when Something Doesn’t Go Right

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Unfortunately dentists and oral surgeons don’t always have all procedures go as planned for their patients. For example, when it comes to wisdom tooth surgery, it is possible for the wrong set of wisdom teeth to be removed as is discussed on the wisdom teeth complications page, see https://www.teethremoval.com/complications.html. Since procedures don’t always go as planned, on this site before guidance for patients who want to be very defensive has been provided, see the post The Defensive Patients Guide to Wisdom Teeth Removal. While patients can sometimes be bad actors and deny that certain information was provided to them prior to a procedure (see the post Patient Recall During Informed Consent for Wisdom Teeth Surgery), dentists and oral surgeons also can behavior badly such as by telling patient’s after their procedure that their condition that resulted could not have possibly … Read more

Patients Wisdom Teeth Extraction Results in Reactive Arthritis

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An interesting article titled “Reactive Arthritis Resulting From Postoperative Complications of Third Molar Extraction: A Case Report,” appears in Cureus in August 23, 2022, written by Lauren Maytin and Jeffrey Morrison (vol. 14, no. 8, pp. e28325). The article presents a case report of a 23 year old woman who develped reactive arthritis after wisdom teeth extraction. In the article the authors discuss a 23 year old woman who had a history of lower back and joint pain but developed more severe of symptoms of bilateral shoulder pain, decreased range of motion in her left shoulder, and worsening lower back after having an infected infected wisdom tooth extracted. She was diagnosed with rheumatoid arthritis and and was prescribed adalimumab. Her laboratory results showed elevated indicators of inflammatory activity that were positive for HLA-B27. The woman presented to two weeks after wisdom … Read more