asymptomatic

The Risk of Future Extraction of Wisdom Teeth

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An interesting study titled “What is the Risk of Future Extraction of Asymptomatic Third Molars? A Systematic Review,” written by Gary F. Bouloux and et al., appears in the May 2015 issue of the Journal of Oral and Maxilofacial Surgery (vol. 73, issue 5). The study attempts to determine the annual and cumulative rate of when asymptomatic wisdom teeth become necessary to remove. The authors state that the management of asymptomatic wisdom teeth is controversial and unresolved. They performed a systematic review of past studies using PubMed, Google Scholar, and the Cochrane Central Register of Controlled Trials on retained wisdom teeth. The authors had several criteria necessary for the study to be included in their analysis. The studies were included if they were an English language publication, were a prospective study design, had more than 50 subjects, had recorded the … Read more

Differing Views in Medicine and Dentistry Applied to Wisdom Teeth

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An interesting article appears in the 2014 version of the Journal of Oral and Maxillofacial Surgery titled “Asymptomatic Third Molars Under Nominalist and Essentialist Lenses,” written by V. Wallace McCarlie and Daniel L. Orr II, pp. 658-659.  The authors define two differente views: 1) essentialism and 2) nominalism and then try to apply them to the management of wisdom teeth. The authors state “Essentialism is the notion that underlying every properly defined disease is an unchanging reality causing illness. Conversely, nominalism is not concerned with underlying causes, but rather with signs and symptoms of illness.” In the article the authors mention a study which says that dentists detect rather than diagnose. The authors later say that detection implies nominalism and diagnosis implies essentialism. The authors give some downsides to both points of view. For example, they say essentialism is less … Read more

What is the Prevalence of Patients with Asymptomatic, Disease-Free Third Molars (Wisdom Teeth)

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An interesting article titled “How Many Patients Have Third Molars and How Many Have One or More Asymptomatic, Disease-Free Third Molars?” appears in the September 2012, supplement 1. (vol. 70, issue 9) of the Journal of Oral and Maxillofacial Surgery written by Thomas B. Dodson, DMD, MPH (pg. S4-S7). The article seems to attempt to arrive at an answer to the question of how many patients really have a wisdom tooth (third molar) that is not causing problems and that has no disease. In the article Dr. Dodson recommends that patients are divided into 4 different categories when having their wisdom teeth evaluated. symptomatic, disease present (based on history and radiological examination) symptomatic, disease absent (includes teething and vague pain symptoms unrelated to wisdom tooth) asymptomatic, disease present (disease is evident from radiological findings or clinical exam but not patient … Read more

The Evidence Base for Third Molar (Wisdom Teeth) Decisions

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An excellent editorial appears in the Journal of Oral and Maxillofacial Surgery in the August 2012 edition titled “Those Who Ignore the Evidence Are Doomed to Misuse It” by Dr. Thomas B. Dodson (70, pages 1765-1767). Dr. Dodson explains how the debate regarding whether or not to either 1) remove asymptomatic, disease-free third molars, or 2) retain asymptomatic, disease-free third molars has become highly controversial. He argues that there are an assortment of viewpoints that play a role here. A) Payer-based clinical decision making: “The payer is the invisible hand in the operatory, influencing the treatment plan with a bold line that determines whether a service is covered or not. With PBCD, there is little regard or sympathy for what the OMS perceives about the individual patients and their circumstances. Thus, PBCD risks moral hazard by pre-empting services that the … Read more