Wisdom Teeth

Factors that Influence Opioid Prescribing After Teeth Removal

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An interesting article titled “Factors influencing opioid prescribing after tooth extraction,” appears in the  Journal of the American Dental Association written by Douglas R. Oyler and et al. (published June 9, 2022). The article seeks to look at specific characteristics that infuence opioid prescribing after tooth extractions to help potentially lead to less opioid that are uncessarily prescibed. The subect of opioids and wisdom teeth extractions has been covered on this site frequently before, see for example the posts, Record Numbers Predicted to Die from Opioids in the US and Dentists Overprescribing Opioids to Adults in the U.S.. Patients in the U.S. are often first exposed to an opioid prescription from a dentist or dental care provider. Even so nowadays many dentists recommend nonopioid analgesics as the first option against pain reflief. In the article the authors reviewed records from … Read more

Shared Medical Appointments for Wisdom Teeth Informed Consent

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In the past informed consent for wisdom teeth surgery has been discussed on this site, see for example the post Informed Consent in Dentistry: Can Change Impact Personal Injury Cases? Often when it comes to have wisdom teeth surgery patients are shown a video discussing risks and benefits and treatment options related to wisdom teeth, then have an opportunity to discuss with their surgeon and ask any questions, and then sign a document acknowledging that they understand the risks and benefits. Such interaction typically places in a one on one setting with just the patient and the doctor. The patient is of course then billed for this appointment and must either pay out of pocket or pay what is remaining from their insurance plan and after meeting any insurance plan deductibles. There are some ways to possibly decrease the cost … Read more

Incorrect Tooth Extraction Protocol

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An interesting article titled “Incorrect tooth extraction – Never say never?” written by McKernon et al. appears in Oral Surgery in 2017 (vol. 10, pp. 30-35). The article discusses development of a protocol for dealing with cases of extracting the wrong tooth. Extracting the wrong wisdom tooth is a possible complication of removal and has occurred before, see http://www.teethremoval.com/complications.html. In the article the authors discuss how checklists are now used during surgery in an attempt to decrease medical errors. Even with these checklists reports of wrong tooth extraction still occur. The authors state that cases of wrong tooth extraction occur about once a week among all dentists in the U.K. The most common reasons for extracting the wrong tooth include cognitive failure and miscommunication. The authors state “We suggest…as human error can never be completely eradicated, a protocol must be … Read more

Rare abscess in chewing muscle after wisdom tooth extraction

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An interesting article titled “A Rare Infratemporal Fossa Abscess of the Lateral Pterygoid” appears in Cureus written by B.S. Daines, R. Varman, and J. Cordero (May 27, 2022, vol. 14, no. 5, pp. e25391). The article discusses how a 26 year old man developed an infratemporal fossa abscess in the lateral pterygoid, a masticatory muscle used for chewing, after having a wisdom tooth extraction. The article discusses how the 26 year old man developed facial swelling after having two upper wisdom teeth extracted. He presented with facial swelling on his left side which was accompanied by constant and dull pain localized to the left face with radiation to the left temple and made worse when he opened his jaw. The man also had a low grade fever and his symptoms persisted even with taking oral amoxicillin for one week and … Read more

How dentists can navigate ethical treatment decisions for patients

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An interesting article titled “How to manage the principal-agent problem in dentistry,” appears in the June 2022 edition of the Journal of the American Dental Association (JADA) written by Ben Balev (no. 153, issue 6, pp. 588-589). The article discusses the principal-agent problem, in which the dentist operates as the agent for the patient who is the principal and there is an imbalance of power between the patient and the dentist in decision making. In the dentist-patient relationship, the dentist has specialized knowledge that the patient lacks, and the patient seeks to make up for their lack of knowledge by having the dentist help in oral health decisions. Such a relationship requires that the patient trusts that the dentist functions in their best interest. However, sometime the patient questions the dentists motives behind their treament recommendations. The patient may wonder … Read more