Using Bupivacaine with Wisdom Teeth Removal Results in Less Opioids Prescribed

An interesting article titled “A Retrospective Cross-Sectional Study of the Effect of Liposomal Bupivacaine on Postoperative Opioid Prescribing After Third Molar Extraction,” written by Stuart E. Lieblich and et al. appears in the Journal of Oral and Maxillofacial Surgery (vol. 79, pp. 1401-1408, 2021). The study seeks to explore if patients who have lower wisdom teeth removed using liposomal bupivacaine need less opioids than those wo do not have liposomal bupivacaine. In the study the authors performed a retrospective study of patients who had undergone wisdom teeth extraction at 2 outpatient oral surgery centers in the United States. Patients had to have been at least 18 years of age and undergoing an elective wisdom tooth removal with 1 partial bony or full bony lower impacted wisdom tooth. A total of 600 patients who underwent wisdom teeth extracted were included in … Read more

Parents Sue After Three Year Old Kansas Boy Died from Dental Work

In July 2021, a three year old boy died after having dental work done in Kansas. A few months later the parents filed a lawsuit against the the dentist, the dental office, the nurse anesthetist, and the anesthesia company. The young boy needed to have some teeth removed due to a gum infection. He went with his mother to two dental offices in southwest Kansas to help choose a dental office. Ultimately a dental office was chosen in Wichita, Kansas which was four hours from their home. According to the timeline of events in the lawsuit, during the boy’s dental work he was given anesthesia with propofol and ketamine by the nurse anesthetist at 7:15 A.M. Around 8 AM the boy was given another dose of propofol by the nurse anesthetist. Around the same time the nurse anesthetist noticed an … Read more

Hallucinations While Taking Anesthesia: Implications for Sexual Assault

In the past it has been discussed how in rare occasions patients (mostly young women) while having wisdom teeth surgery are sexually assaulted. This is discussed at http://www.teethremoval.com/sexual_assault_under_anesthesia_for_wisdom_teeth_removal.html and in several blog posts such as In Light of the Allegations of Child Sex Abuse at Penn State…, Dentist Who Groped Patients Sentenced to Jail, and Recent Cases of Dentist Assistant Sexual Assault During Wisdom Teeth Removal. Many times these patients go on to sue either the dental assistance or dentist or oral surgeon who committed the sexual assault. However, most of these same patients are given drugs during the surgery that can cause sexual hallucinations. Thus it is typical for the legal team defending the dental assistance or dentist or oral surgeon to argue that the patient was dreaming and no actual sexual assault occurred. In some cases it is … Read more

Comparing Injectable Anesthetics for Dentistry

A review articled carried out by the Cochrane Database of Systematic Reviews titled “Injectable local anaesthetic agents for dental anaesthesia (Review)” written by St. George et al. in 2018 (no. 7, art. no. CD006487) explored the success of local anesthetics used by dentists. Procedures in dentistry that use local anesthetics include endodontic treatment, placement of restorations, and extraction of teeth. The researchers wanted to determine if one form of anesthetic worked better than others in different scenarios. The researchers defined success for an anesthetic based on the absence of pain during the procedure. They sought out to also explore the speed of onset and duration of anesthesia as well as the systemic and local adverse effects. The researchers had a very thorough search that resulted in 123 studies which was later reduced down to 68 studies and compared 14 different … Read more

Is there a Difference in Complications following Wisdom Teeth Removal when using Local Anesthesia versus General Anesthesia?

An interesting article titled “Retrospective multivariable comparison for complications of third molar surgery performed under general versus local anaesthesia” written by Beteramia et al. appears in Oral Surgery in 2019 (vol. 12, pp. 96-103). The article seeks to explore if there is a difference in the amount of complications that occur during or after wisdom teeth surgery when using local anesthesia or when using general anesthesia. In the article the authors discuss complications that can happen during wisdom teeth removal including excessive bleeding, injury to the inferior alveolar and lingual nerves, damage to the adjacent second molar, alveolar bone fracture, and displacement of tooth fragments into fascial spaces and complications that can happen after wisdom teeth removal including alveolar osteitis (dry socket), a secondary infection, and hemorrhage. These complications are discussed more over at http://www.teethremoval.com/complications.html. The authors further discuss how … Read more