controversy

Management of Wisdom Teeth without Symptoms

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An article by Raymond P. White and William R. Proffit titled “Evaluation and management of asymptomatic third molars: Lack of symptoms does not equate to lack of pathology” appeared in the July 2011 issue of the American Journal of Orthodontics and Dentofacial Orthopedics (Vol 140, Issue 1). The article states “Some patients have third molars that are “symptom free and pathology free.” More often, however, third molars are “symptom free, and pathology exists,” requiring a clinical or radiographic examination for confirmation.” The authors state that a recent report suggests that limited periodontal examination in the United States in the National Health and Nutrition Estimates Survey…”underestimated the prevalence of periodontal disease.” A study carried out at the University of North Carolina and the University of Kentucky is mentioned which included 409 healthy young adults who averaged 25 years old and had … 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

An Oral Surgeon and His Quest To Educate

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I found the website of an Oral Surgeon living in England and teaching at the King’s College Dental School who has started a website to educate patients. His website addresses many of the issues surrounding wisdom teeth removal and their removal. I am suprised I did not find it until this month as looks like it has been around since 2007. On the website it states “As an Oral Surgeon, I find the more information you can give patients and dentists the better.” I feel the goals of his site are somewhat aligned with those of my own. He is also very knowledagle on different policy issues occuring in the UK. The website includes some very detailed explanations of problems and complications that can occur form tooth removal. http://www.exodontia.info/ExodontiaWarnings.html The website also includes some of the guidelines governing the practice … Read more