Wisdom Teeth

Does Not Treating Asymptomatic Wisdom Teeth Cause Harm?

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An interesting article appears in the July 2015, British Dental Journal, titled “Revolution vs status quo? Non-intervention strategy of asymptomatic third molars causes harm” written by V. Toedtling and J. M. Yates (vol. 219, no. 1, pp. 11-12.) The article addresses how the Faculty of Dental Surgery of the Royal College of Surgeons of England has asked the National Institute for Health Care Excellence (NICE) to re-assess their guidance on wisdom teeth extractions. This is because the group and doctors feel that there is an increasing amount of distal-cervical caries (cavities) in lower second molar teeth (teeth right next to wisdom teeth) when associated with asymptomatic partially erupted mesial or horizontally impacted lower wisdom teeth (mandibular third molars). The authors say that NICE has been reluctant to re-appraise their 2000 guidance and guidelines on wisdom teeth removal. The authors point … Read more

An Australian perspective of removing or retaining wisdom teeth (third molars)

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An article titled “Cost effectiveness modelling of a ‘watchful monitoring strategy’ for impacted third molars vs prophylactic removal under GA: an Australian perspective” appeared in the July 2015, British Dental Journal and written by A.A. Anjrini, E. Kruger, and M. Tennant (issue 219, pp. 19-23). The article discusses the direct and indirect costs associated with removing impacted wisdom teeth in Australia. A news article appearing on the Australian ABC Science (http://www.abc.net.au/science/articles/2015/08/17/4283895.htm) titled “Wisdom teeth: are we removing them more often than needed?” by Anna Salleh and written on August 17, 2015, discusses some of the points made in the journal article. The authors were interested in determining if a watchful waiting monitoring strategy should be used for impacted wisdom teeth or if a prophylactic strategy should be used. They looked at hospitalization data for impacted wisdom teeth removal for 2008 … Read more

Measuring Lingual Position of Lower Wisdom Teeth

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An interesting study titled “Measurement of the Lingual Position of the Lower Third Molar Roots Using Cone-Beam Computed Tomography,” appears in the January 2015 issue of the Journal of Oral and Maxilofacial Surgery (vol. 73, issue 1) and written by Yusuf Emes and et al. The authors set out to use Cone-beam computed tomography (CBCT) to evaluate the proximity of lower wisdom teeth roots to the lingual cortex, which can be used to determine the potential risk of root displacement during lower wisdom teeth removal. The study used CBCT images of 32 impacted lower wisdom teeth of 31 patients (5 men and 26 women). The images were collected for reasons not related to surgery including impacted teeth, dental implants, and cysts of the jaws. An evaluation was performed independently by 2 trained oral and maxillofacial surgeons who were experienced in … Read more

Comparing Narcotic Prescribing Habits For Oral Surgeons in the U.S. and Canada

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In a previous blog post titled “Do Oral Surgeons Prescribe Too Many Narcotics for use after Wisdom Teeth Removal?” the issue explored was that of whether or not oral surgeons prescribe more than an adequate amount of narcotic pain killers to young adults after wisdom teeth extraction. The article that found around 25% or so of the study respondents prescribe what the authors of the article declared as too many narcotics to control pain which opened the possibility of non-medical use. A new article titled “Comparison of Narcotic Prescribing Habits and Other Methods of Pain Control by Oral and Maxillofacial Surgeons in the United States and Canada,” sought to explore whether Canadian oral surgeons have similar narcotic prescribing habits. This article was written by Bruce R. Pynn and Daniel M. Laskin and appeared in the December 2014 issue of the … Read more

Exploring the Risk Factors for Injury To Nerves During Wisdom Teeth Removal

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An interesting article titled “Risk Factors for Permanent Injury of Inferior Alveolar and Lingual Nerves During Third Molar Surgery,” appears in The Journal of Oral and Maxillofacial Surgery, vol. 72, issue 12, and written by Edward Nguyen and et al. The article assesses the incidence of and risk factors for permanent neurologic injuries to the inferior alveolar nerve (IAN) or lingual nerve (LN) after wisdom teeth removal. The article states “It has been well documented in the literature that the risk factors for IAN and LN injuries include increasing age, unerupted teeth, deep impaction, distoangular impaction, irregular root morphology, lack of clinician experience, lingual flap and retraction, and radiographic signs of proximity of the third molar to the IAN canal. The main forms of altered sensation that can occur include paraesthesia, anesthesia, or dysesthesia, which may be temporary or permanent. The … Read more