Wisdom Teeth

Avoiding Amoxicillin During Wisdom Teeth: What are the Possible Problems

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An interesting article titled “Dental Care Professionals Should Avoid the Administration of Amoxicillin in Healthy Patients During Third Molar Surgery: Is Antibiotic Resistence the Only Problem?” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Othoniel H. Aragon-Martinez and et al. (vol. 74, pp. 1512-1513). The authors attempt to explain why amoxicillin should not be used during wisdom teeth surgery. Amoxicillin is commonly used to prevent infections. Information from high quality clinical trials has shown that amoxicillin is not effective to reduce the risk of wound infections when it is received both preoperatively and postoperatively.  Recent evidence has shown that the administration of 250 mg of amoxicillin in healthy volunteers every 8 hours for 7 days produces  antibiotic resistance. The authors also discuss the topic of dysbiosis. Dysbiosis is a detrimental modification in the composition of the microbiome alongside altered microflora functions, which can be produced by antibiotic exposure, … Read more

Are There Differences in Complications After Wisdom Teeth Surgery Depending on the Sedation Received?

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An interesting article titled “Complications of Moderate Sedation Versus Deep Sedation/General Anesthesia for Adolescent Patients Undergoing Third Molar Extraction” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Gino Inverso and et al. (vol. 74, pp. 474-479).  The authors set out to determine if there is any difference in complications occurring after wisdom teeth surgery when patients are given either moderate sedation or deep sedation. For patients undergoing wisdom teeth surgery they may have some say in what level of sedation they receive and it may also be based on the desires of the surgeon. Specifically the authors examined the complications resulting from moderate sedation versus deep sedation/general anesthesia for adolescent patients undergoing wisdom teeth extraction. They sought to determine if any differences in complication risk exist between the two levels of sedation. The authors explored a database commissioned by the the American Association of Oral and Maxillofacial Surgeons … Read more

Using Dexmedetomidine For Wisdom Teeth Surgery

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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 … Read more

Retrieving a Broken Dental Needle Using a Minimally Invasive Technique

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An interesting article titled “Use of Intraoperative Navigation for Minimally Invasive Retrieval of a Broken Dental Needle” appears in the 2015 Journal of Oral and Maxillofacial Surgery and written by Kyle M. Stein (vol. 73, pp. 1911-1916). The article describes retrieving a broken dental needle using a Medtronic StealthStation S7 surgical navigation system. The use of disposable needles in dentistry has rendered the occurrence of needle breakage an extremely rare event. However, this complication continues to occur, and can be caused by improper technique, inappropriate armamentarium, and unexpected patient movement. I have described a few cases of this occuring on the wisdom teeth complications page at http://www.teethremoval.com/complications.html. In almost every case, needle breakage occurs when an inferior alveolar nerve block is administered with 30-gauge short needles. In the article a case of a 13 year old female had a broken dental … Read more

Do Mesial Angled Wisdom Teeth Cause Problems to Adjacent Second Molars

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An interesting article titled “Mesial Inclination of Impacted Third Molars and Its Propensity to Stimulate External Root Resorption in Second Molars—A Cone-Beam Computed Tomographic Evaluation” written by Anne Caroline Costa Oenning and et al. appears in the 2015 Journal of Oral and Maxillofacial Surgery (vol. 73, pp. 379-386). The authors explore cone-beam computed tomography (CBCT) scans to look at the teeth in the mouth. They look at the  presence of external root resorption (ERR) in second molars adjacent to horizontally and mesioangular impacted mandibular wisdom teeth. Unlike cavities, ERR is usually asymptomatic and aseptic, unless the pulp cavity has been involved or the lesion has been secondarily infected. Literature attributes the occurrence of this resorption to pressure from an adjacent impacted tooth. This pressure can activate clastic cells responsible for triggering resorption. Studies of periapical and panoramic radiographs have looked … Read more