dentist

Dental Plaque May Trigger Blood Clots

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Oral bacteria that escape into the bloodstream are able to cause blood clots and trigger life-threatening endocarditis. Streptococcus gordonii is a normal inhabitant of the mouth and contributes to plaque that forms on the surface of teeth. However, if these bacteria enter into the blood stream through bleeding gums they can start to wreak havoc by masquerading as human proteins. Researchers from the University of Bristol and the Royal College of Surgeons in Ireland (RCSI) have discovered that S. gordonii is able to produce a molecule on its surface that lets it mimic the human protein fibrinogen — a blood-clotting factor. This activates the platelets which then clump inside blood vessels. These unwanted blood clots will then encase the bacteria, protecting them from the immune system and from antibiotics that might be used to treat infection. Platelet clumping can lead to … Read more

Oral Surgeon Investigated for Reusing Needles and Syringes

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The Colorado Department of Public Health has released a lengthy document regarding an oral surgeon regarding unsafe injections. The document is from July 20, 2012, and is located over at http://www.cdphe.state.co.us/dc/Epidemiology/dentistFAQs.pdf. The document states: “Between September 1999 and June 2011, syringes and needles were re-used for multiple patients to give intravenous (IV) medications, including sedation. The IV medications were given during oral and facial surgery procedures. Needles and syringes were used repeatedly, often for days at a time. Because there can be a small amount of blood that remains in syringes and needles after an injection through an IV line, there is a risk of spread of bloodborne viruses, such as HIV, hepatitis B, and hepatitis C, between patients.” Patients who saw the oral surgeon in question were sent a mailing if they could be identified via medical records and … Read more

Third Molars (aka Wisdom Teeth): Kandasamy vs White and Proffit

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Like usual there are often heated exchanges over the management of wisdom teeth (third molars). Back in November 2011, in the American Journal of Orthodontics and Dentofacial Orthopedics (vol. 140, issue 5)  there was an exchange regarding two previous articles that had appeared and consequent exchange (White RP Jr, Proffit WR. Evaluation and management of asymptomatic third molars: lack of symptoms does not equate to lack of pathology. Am J Orthod Dentofacial Orthop 2011;140:10-6; and Kandasamy S. Evaluation and management of asymptomatic third molars: watchful monitoring is a low-risk alternative to extraction. Am J Orthod Dentofacial Orthop 2011;140:11-7) The articles in question I am referring to here are “Third molars” by Raymond P. White, Jr, and William R. Proffit in the American Journal of Orthodontics and Dentofacial Orthopedics (vol. 140, issue 5, pages 600-601) and Author’s response by Sanjivan Kandasamy … Read more

Death and Greed at the Dentist: Is Your Child at Risk?

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A new investigation came out recently by ABC News appearing on both “Nightline” and “World News With Diane Sawyer” looking at sedation deaths from dentistry. The story is located over on the ABC News website which appeared on July 12, 2012 and is titled “Death, Greet at the Dentist: American Children at Risk.” A synopsis of the investigation appeared on drbicuspid.com on July 13, 2012, titled “ABC News spotlights pediatric dental sedation risks.” The story over on ABC News opens up with “American children are being put at risk by inadequately trained dentists who often seek to enhance profits by sedating their young patients for even routine tooth cleaning and cavity treatments.” In the segment on “Nightline” Brian Ross says “…it is a scandal in many cases driven by dentists who are told they can increase their bottom line. Hundreds … 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