complications

The Costs Associated with Third Molars (Wisdom Teeth)

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An interesting articled by George M. Koumaras titled “What Costs Are Associated With the Management of Third Molars?” appears in the 2012 J Oral Maxillofac Surg vol. 70, pp. 8-10, supp. 1. The article attempts to look at the costs associated with asymptomatic, disease-free, third molars (wisdom teeth). Three scenarios were explored by the author: scenario 1 (nonoperative management): retention of asymptomatic, disease-free third molars and monitoring for 20 years from age 18 to 38 years scenario 2 (operative management): removal of 2 asymptomatic, disease-free, bony impacted third molars for 18-year-old patients using general anesthesia (30 minutes) in an office-based ambulatory setting scenario 3 (failure of nonoperative management): removal of 1 previously asymptomatic, disease-free, bony impacted third molar after 10 years of follow-up in a now 28-year-old patient using general anesthesia (30 minutes) in an office-based ambulatory setting.” The author … Read more

Planning Intravenous Sedation for Wisdom Teeth Surgery

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An article (in press at the time of writing this -2012) appears in the International Journal of Oral and Maxilofacial Surgery titled “Does planned intravenous sedation affect preoperative anxiety in patients?” by M. Seto, Y. Sakamoto, H. Takahashi, R. Kita, and T. Kikuta. The authors set out to evaluate The Spielberger’s State-Trait Anxiety Inventory (STAI) which can be used to evaluate levels of state and trait anxiety. State anxiety is defined as a subjective feeling of nervousness, whereas trait anxiety is defined as an individual’s underlying tendency to perceive a situation as stressful or threatening. One hundred and eleven (111) Japanese patients who were scheduled to have wisdom teeth extracted under local anesthesia were evaluated. STAI evaluates the degree anxiety based on 5 stages. The article states “The authors assessed preoperative anxiety using STAI at the initial visit and recommended … Read more

Improving Patient Safety: Updates on Oral and Maxillofacial Surgery

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In a recent blog post I discussed how a few new videos have appeared in recent months related to oral and maxillofacial surgery Videos Related to Oral and Maxillofacial Surgery. The American Association of Oral and Maxillofacial Surgeons (AAOMS) has also updated several sections of their website in the last year or so. They now have a section titled Orthodontics and Oral Surgery where they have videos related to showcasing various techniques that oral and maxillofacial surgeons and orthodontists perform. In addition they have updated and written a new page titled “Culture of Safety“. The page is a welcome addition and discusses how safety is the number one priority in the oral and maxillofacial surgery office. Now I wanted to take a moment to respond to this page and some other developments I have seen lately across the blogosphere. 1) … Read more

The Misbehaving Tooth Fairy

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In the article “The tooth fairy and malpractice” by Sian Ludman, Hamid Daya, Polly S Richards, and Adam Fox, in BMJ Christmas 2012, 345, e3027, a very interesting discussion is made of the tooth fairy. The article states “We are concerned that the actions of the mythical character at the root of this report must be brought to the attention of the medical community, as it seems to represent the first signs of a worrying new trend in malpractice.” The tooth fairy is widely considered to be benevolent but the authors present a disturbing report. A discussion is made of an 8 year old who presented with a foreign body in the left external auditory meatus (which showed up on a CT scan). The image is in the report. The parents of the boy discussed how three years earlier the … Read more

Exploring Giving Antibiotics Before Third Molar Surgery (Wisdom Teeth Removal) in Spain

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An issue that one asks when having third molar surgery (wisdom teeth removal) is one whether should have antibiotics administered before or after surgery (or not at all). See for example http://www.teethremoval.com/antibiotic_resistance.html In a recent article appearing in J Evid Base Dent Pract 2012, issue 12, pp. 149-150, Manal A. Awad, reviewed a study exploring amoxicillin administration to those who were having wisdom teeth extracted. The original study was titled “Efficacy of amoxicillin treatment in preventing postoperative complications in patients undergoing third molar surgery: a prospective, randomized, double-blind controlled study,” by Lopez-Cedrun JL, Pijoan JI, Fernandez S, and Santamaria J, Hernandez G and appeared in the electronic 2011 version pages 5 -14, issue 69, number 6. It is well known that amoxicillin is useful in treating oral infections. In the study 123 healthy patients between the ages of 18 and … Read more