What to do with an Inverted (Upside Down) Impacted Wisdom Tooth?

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An interesting article titled “An unusual case of an inverted and impacted maxillary third molar,” written by Rammal and Alfonso appears in Oral Surgery in 2014 (vol. 7, pp. 109–111). The article discusses a case of an inverted and impacted upper wisdom tooth. In the article the authors discuss how there are seven possible positions that a tooth can be classified into and one of these is the inverted position where the the root apex faces the alveolar crest and the crown faces the maxillary sinus. In such a presentation the tooth appears as if it is growing into the maxillary sinus and the tooth clearly has no use for chewing in the mouth. The authors state: While inverted impacted third molars [wisdom teeth] remain dormant without significant manifestation, removal presents difficulty because of the need to remove large amounts … Read more

Improving the Oral Health of Children

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An interesting article titled “Childhood lasts a lifetime” written by Benjamin appears in the British Dental Journal (Apr. 20, 2018). The article discusses the epidemic of child tooth decay in the United Kingdom (UK) and that good oral health is important for children. In the article the author states “A child’s early years are crucial to her or his long-term mental, physical and emotional wellbeing. So it’s important to remember that everything we do affects children; how we treat them, how we speak to them, what we feed them, how we teach them to take care of their bodies. All of this matters to help children to develop into fit and healthy adults.” In the article the authors mentions some troubling statistics in the UK. One in four children suffer from tooth decay by the age of five and tooth … Read more

An Index to Assess Surgical Difficulty of Impacted Wisdom Teeth

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An interesting article titled “Development of a New Index to Assess the Difficulty Level of Surgical Removal of Impacted Mandibular Third Molars in an Asian Population,” written by Zhang et al. appears in the 2019 edition of the Journal of Oral and Maxillofacial Surgery. The article discusses development of an index to determine the surgical difficulty of impacted lower wisdom teeth. The authors discuss how historically the Pell and Gregory classification and the Winter classification provide a simple judgment on the difficulty level of tooth extraction. They also discuss the Pederson scoring system which assesses the difficulty of extracting impacted wisdom teeth using three factors using the position of the wisdom tooth, the relative depth, and the relation with the ramus. The Pederson scoring system calculates a score from 3 to 10 based on these three factors and then assigns … Read more

Reoperation in Wisdom Teeth Having Coronectomy

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An interesting article titled “What Are the Parameters for Reoperation in Mandibular Third Molars Submitted to Coronectomy? A Systematic Review,” appears in the 2019 edition of the Journal of Oral and Maxillofacial Surgery written by Barcellos et al. The article seeks to identify factors that are associated with needing a reoperation after having a lower wisdom tooth coronectomy. Coronectomy is often suggested to treat wisdom teeth where their is a belief their is a high chance of damage to the inferior alveolar nerve with their removal see for example Do People Know about Coronectomy For Management of Wisdom Teeth? and Coronectomy Five Year Follow Up. Typically such risk is assessed using panoramic radiography and cone-beam computed tomography. In the article the authors implemented a systematic review exploring articles on wisdom teeth coronectomy up until June 2018. A total of 362 studies … Read more

Cosmetic Dentistry in the Era of COVID-19

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With coronavirus (COVID-19) cases in the U.S. continuing to reach record highs – averaging over 100,000 cases this past week in the U.S., as shown for example by the New York Times, you may be surprised to hear that many dentists are reporting a boom in interest in cosmetic dentistry. As has been discussed before on this site, this is because of widespread adoption of teledentistry, see the prior post Delivering Dentistry and Counseling to Patients using Telemedicine. This is also known as the Zoom boom, due to the popularly of software made by the company Zoom Video Communications, Inc., although many other video conferencing platforms exist such as WhatsApp, Microsoft Teams, Cisco WebEx, and Skype. Patients also have extra money to spend, that may have been used in the past to spend on travel and leisure activities that now … Read more