Are Migraine Related Changes Related to Impaired Cognition?

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A recent study titled “Structural Brain Changes in Migraine,” appears in The Journal of the American Medical Association, November 14, 2012, vol. 308, no. 13, pp. 1189-1897, by Inge H. Palm-Meinders et al. The study set out to follow-up the 2000 Cerebral Abnormalities in Migraine, an Epidemiological Risk Analysis cohort (CAMERA-1), a prospective population based observational study of Dutch participants with migraine and an age and sex matched control group. This study showed that women with migraines were more likely to have scattered areas of white mater changes on MRI scans. The current study is known as CAMERA-2 and the researchers wanted to determine  whether women or men with migraine have a higher incidence of brain lesions 9 years after initial MRI, whether migraine frequency was associated with progression of brain lesions, and whether progression of brain lesions was associated … Read more

Oklahoma Dentist Disciplinary Database

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A lot of media publicity has occurred regarding a case that appeared last month where patients of an oral surgeon in Oklahoma were asked to get tested for HIV and hepatitis after it was found that potentially lax sterilization procedures were used. More on this case is discussed over at Dental Patients Warned of Possible HIV and Hepatitis Exposure Due to Oral Surgeon’s Practices for example. The Tulsa World has been prompted to publish a searchable database of all disciplinary actions taken against dentists, in the state of Oklahoma from January 2000, to January 2013, after the case involving lax sterilization procedures came to light. In that case one patient had four third molars (wisdom teeth) removed and was allegedly given sedation by a dental assistant who should not have been giving sedation. She later developed an infection and liver … Read more

Looking at the Concept of Prevention in Dentistry

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An interesting article written by Jay W. Friedman, DDS, MPH, appears in J Evid Base Dent Pract, vol. 12, pp. 53 – 54, 2012. In the article a discussion of three different types of prevention is made. primary prevention secondary prevention tertiary prevention Primary prevention is described as the well known prevention in which one attempts to not have any dental caries, not have any periodontal disease, and not have any loss of teeth. This form of prevention is when one regularly brushes their teeth, flosses, has a dental cleaning, and radiographs performed. The author discusses how typically dentists recommend 6 month intervals between examinations and cleanings. He then says “Patients who form minimal calculus and have no periodontal disease likewise do not need semiannual prophylaxis, or additional service…Lacking evidence of need, this is not prevention but rather FUN (functionally … Read more

Bupa Ends Covering Wisdom Teeth Extractions Deeming Them Unnecessary

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There is a lot of debate regarding removing asymptomatic third molars (wisdom teeth). Those who argue against removing asymptomatic wisdom teeth (retaining) are often accused of trying to save the insurance industry money (See for example Rogue Dentist’s Crusade), while those who argue for extracting asymptomatic wisdom teeth for preventative purposes are often accused of being interested in making more money due to the commonly used fee for service health care system. Somehow in the hoopla the patient’s health seems to take a back seat to some party making (or saving) money. Recently an article came out in London in the Times titled “Health insurer’s chief takes the knife to ‘unnecessary surgery” by Nic Fildes and Andrew Clark, March 13, 2013. The article opens by saying “Want to get your wisdom teeth extracted? Don’t ask Bupa, which is cutting back on … Read more

Systematic Review of Prophylactic Extraction of Third Molars: From Brazil

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Many reviews have been conducted in recent years to determine if healthy third molars (known as wisdom teeth) should be prophylacticly extracted as in removed before causing problems. A new study by Moacir Guilherme da Costa and four other researchers titled “Is there justification for prophylactic extraction of third molars? A systematic review,” appears in Braz Oral Res., (São Paulo) 2013 Mar-Apr;27(2):183-8. The article discusses how in the United States roughly 10 million wisdom teeth are extracted from around 5 million individuals each year. The article discuss how several reasons are usually given for extracting wisdom teeth pericoronitis periodontal defects in the distal region of the second molar caries in the third or second molars different types of odontogenic cysts and tumors crowding of the lower incisors indications for orthodontic, prosthetic or restorative purposes The authors state how the majority … Read more