Behavioral Treatment for Migraine Headaches

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A recently study titled Direct Costs of Preventive Headache Treatments: Comparison of Behavioral and Pharmacologic Approaches appearing in Headache: The Journal of Head and Face Pain, 51 (6): 985 -991, June 2011, and written by Allison M. Shafer et al., finds that treating chronic migraines using inexpensive prophylactic medicines such as beta-blockers or tricyclic antidepressants and behavioral approaches such as relaxation training, biofeedback, cognitive behavioral therapy, and stress management are a low cost and effective treatment option particularly after 1 year of treatment. The authors used a cost minimization analysis and found that after 1 year, the cost of minimal-contact behavioral treatment was cheaper than the least expensive headache treatment medications. Minimal-contact or home based intervention is when a patient sees a therapist for around 3 or 4 visits and  largely practices the behavioral techniques at home through the use of … Read more

In Light of the Allegations of Child Sex Abuse at Penn State…

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By now I am sure everyone has at least heard that Joe Paterno has been fired as the head coach of the Penn State college football team due to child sex abuse allegations made against one of his former assistant coaches. As discussed a few times on this blog and as indicated as a potential unfortunate risk of having wisdom teeth extracted there is the possibility of being sexually assaulted while under anesthesia to have wisdom teeth removed. As expanded on and discussed at http://www.teethremoval.com/sexual_assault_under_anesthesia_for_wisdom_teeth_removal.html many of the drugs that dentists and oral surgeons give during the surgery can cause in rare instances sexual hallucinations. This means that it is possible for no repercussions and/or loss of license and/or jail time to occur and it can be difficult to distinguish between dreams and actual molestation in the court of law. In … Read more

What to Do about the Fourth Molar: Similar Management Strategies as the Third Molar aka Wisdom Tooth?

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So wisdom teeth are also known as third molars but did you know that there are also fourth molars in a small subset of patients? A recent study was performed by the United States at an Air Base in Japan which is currently in press to appear in the Journal of Oral and Maxillofacial Surgery titeld Prevalence and Management of Fourth Molars: A Retrospective Study and Literature Review by Khurram M. Shahzad and Lawrence E. Roth, 2011. In the study conducted 409 patients were referred for a third molar (wisdom teeth) consultation. Two of 227 white patients (0.9%) had a fourth molar and 6 of 94 black patients (6.4%) had a fourth molar. One of the other 84 patients (1.2%) also had a fourth molar. Of these patients with a fourth molar 5 out of 9 (55%) had only 1 … Read more

Research During Residency for Oral Surgeons?

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Earlier this year over the summer an article appeared in the Journal of Oral and Maxillofacial Surgery discussing the attitudes of program directors and residents toward performing research during residency. I commented on this article here https://blog.teethremoval.com/the-lack-of-importance-of-research-in-oral-and-maxillofacial-surgery-residency-programs/ A new article has appeared in the Journal of Oral and Maxillofacial Surgery written by Dr. James R. Hupp titled Research During Residency – Should it be Mandated? (vol. 69, pages 2685-2687, 2011). In the article is a discussion of research and whether or not it should be performed by oral surgeons in residency. Dr. Hupp discuses his own experience with research work and then questions if the current accreditation standards require all Oral and Maxillofacial Surgery residents to do research. He says: “Now the question becomes, should our standards require all residents to have the opportunity to conduct research and, in my … Read more

The Cyberchondriac: Managing the Difficult Patient

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There is an interesting series over at QuantiaMD on Managing the Difficult Patient. Presentations are available for viewing as long as you sign up for with your email. One such presentation was originally called The Patient Who Knows too much but has been changed to The Cyberchondriac. http://quantiamd.com/player/wywzswwh?courseid=31844 Mary Modahl  who is QuantiaMD Chief Communications Officer said after the original title was added  “‘The Patient Who Knows Too Much’ is a very poor title. Certainly a patient can never know too much. In every way, we’re supportive of doctors meeting their patients’ need for care.” Dr. Joseph Scherger, vice president for primary care at Eisenhower Medical Center in Rancho Mirage, California, defines a Cyberchondriac in the presentation: “This is a patient who is on the internet…indiscriminate with the material they are reading…they consider themselves an expert yet often their true medical … Read more