Profit Motives in Oral and Maxillofacial Surgery Utilizing Sedation

Recently on this site it was discussed how guidelines have come out from the American Academy of Pediatric Dentistry (AAPD) and American Academy of Pediatrics (AAP) recommending when deep sedation or general anesthesia is given to children in dental offices there should be two trained individuals present. One individual should provide the dentistry and the other individual is responsible to administer the sedation or anesthesia and to observe the patient for any adverse events. This goes against the single provider model that has been advocated by the American Association of Oral and Maxillofacial Surgeons (AAOMS) and is typically utilized for wisdom teeth removal in the United States of America, where the oral surgeon performs both the dentistry and the administration of sedation or anesthesia. Some have criticized the AAOMS position of a single provider model for its focus on profit … Read more

Oral and Maxillofacial Surgeons Utilizing New Methods To Reach Patients for Wisdom Teeth Management

According to the March/April 2019 and May/June 2019 editions of AAOMS Today, the American Association of Oral and Maxillofacial Surgeons (AAOMS) is utilizing new methods to reach patients for wisdom teeth management. AAOMS is utilizing methods taking advantage of public service announcements (PSA) at airports, on radio, and on television (TV). AAOMS is also utilizing new infographics on websites and social media. According to page 22 in the March/April 2019 issue of AAOMS Today, in mid 2018 AAOMS launched airport PSAs with signage saying “Pain or no pain, your wisdom teeth should be checked every year.” In addition a picture of either a young woman or young man is featured along with the AAOMS logo, the tagline of AAOMS stating “Oral and maxillofacial surgeons: The experts in face, mouth and jaw surgery”, and also telling patients to find a surgeon … Read more

Indications for Removal of Wisdom Teeth

These days in 2019 the American Association of Oral and Maxillofacial Surgeons (AAOMS) has a page on their website titled “Third Molar Research News” that contains information on how to manage wisdom teeth, see https://www.aaoms.org/media/third-molar-research-news. How to manage wisdom teeth continues to be contested when wisdom teeth are healthy and not causing symptoms, see for example http://www.teethremoval.com/controversy.html. One of the documents AAOMS provides is titled “The Management of Impacted Third Molar Teeth” and contains a long list of what they consider as medically necessary and valid reasons for surgical removal of wisdom teeth, see https://www.aaoms.org/docs/practice_resources/clinical_resources/impacted_third_molars.pdf. However at least two of these reasons seem to be unsupported by current scientific evidence and thinking. The first reason in doubt given by AAOMS as a valid reason which seems to lack evidence is insufficient space to accommodate erupting tooth or teeth. This reason … Read more

Oral and Maxillofacial Surgeons Current Perspectives on Opioid Prescribing

Recently, both insurance companies and politicians in the U.S. have intensified their efforts to limit patients undergoing wisdom teeth surgery to have access to opioids to manage their pain. See the posts on this site: 1) Insurance Companies Limiting Access to Opioids After Wisdom Teeth Surgery and 2) The Effect of Opioid Prescription Limits For Wisdom Teeth Removal. Such efforts have intensified due to recent research showing that opioid prescriptions taken by young adults following wisdom teeth removal has contributed to the opioid addiction and abuse epidemic in the U.S. However, lost in these conversations is the perspectives from oral and maxillofacial surgeons. According to the 2017 white paper by the American Association of Oral and Maxillofacial Surgeons (AAOMS) titled “Opioid Prescribing: Acute and Postoperative Pain Management,” these surgeons feel: “… the practitioner-patient relationship must be upheld, allowing for practitioner … Read more

Delivering Sedation in Dentistry

It has become increasing popular to deliver sedation to patients receiving dental work. Sedation is defined as the deliberate drug-induced depression of consciousness used to reduce anxiety and awareness associated with unpleasant medical procedures. Sedation is used to reduce anxiety.  In some cases dentists or oral surgeons deliver both the dental work and the sedation, while in others there is a separate anesthesiologist to do so. One should always verify proper training and license prior to undertaking any sedation from a healthcare professional. Sedation is generally considered very safe as long as it is performed by an appropriately trained practitioner in a monitored environment. Sedation dentistry uses different approaches depending on personal choice and comfort. In the order of increasing anesthesia these are local anesthesia, minimal sedation, nitrous oxide/oxygen, moderate (conscious) sedation, deep sedation, and general anesthesia. A more thorough discussion … Read more