oral surgery

Are There Differences in Complications After Wisdom Teeth Surgery Depending on the Sedation Received?

by

An interesting article titled “Complications of Moderate Sedation Versus Deep Sedation/General Anesthesia for Adolescent Patients Undergoing Third Molar Extraction” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Gino Inverso and et al. (vol. 74, pp. 474-479).  The authors set out to determine if there is any difference in complications occurring after wisdom teeth surgery when patients are given either moderate sedation or deep sedation. For patients undergoing wisdom teeth surgery they may have some say in what level of sedation they receive and it may also be based on the desires of the surgeon. Specifically the authors examined the complications resulting from moderate sedation versus deep sedation/general anesthesia for adolescent patients undergoing wisdom teeth extraction. They sought to determine if any differences in complication risk exist between the two levels of sedation. The authors explored a database commissioned by the the American Association of Oral and Maxillofacial Surgeons … Read more

Using Dexmedetomidine For Wisdom Teeth Surgery

by

An interesting article titled “Sedation Protocol Using Dexmedetomidine for Third Molar Extraction” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Dae-Seung Ryu and et. al. (vol. 74, pp. 926.e1-926.e7). The article seems to determine a sedation protocol for dexmedetomidine. The authors state that IV sedation is often given in cases of wisdom teeth surgery with midazolam being a medication commonly used. When midazolam is combined with opioids it can cause respiratory depression. Dexmedetomidine is an alpa2-agonist acting on adrenoceptors in many tissues, including those in the nervous, cardiovascular, and respiratory systems. Compared with midazolam, the major advantage of dexmedetomidine is its minimal effect on the respiratory system. It also produces an analgesic effect which can help alleviate the sensation of pain after tooth extraction. The authors set out to study the pain, patient satisfaction, sedation depth, and adverse effects after wisdom teeth extraction using dexmedetomidine and to compare IV and intranasal (IN) routes of administration. The … Read more

Bleeding After Dental Extractions in Patients on Warfarin

by

An interesting article titled “Postoperative Bleeding Following Dental Extractions in Patients Anticoagulated With Warfarin” written by Anthony Febbo and et al. appears in the 2016 Journal or Oral and Maxilofacial Surgery (vol. 74, pp. 1518-1523). The article sought to explore the risk of bleeding in patients on warfarin after dental extraction. Warfarin is the most common anticoagulant used in Australia which can be used to prevent life-threatening thromboembolic events, such as stroke and deep vein thrombosis from occuring in patients at risk. Varying viewing points exisist as how to best handle these patients when a tooth or teeth need to be extracted. Some options include stopping the anticoagulant before extraction or continuing to use it while local hemostatic techniques are used. However ceasing the anticoagulant could be deadly so it is not generally used. The therapeutic effect of warfarin is … Read more

What Can a Surgeon Do to Prevent Opioid Abuse

by

An interesting article titled “The Surgeon’s Roles in Stemming the Prescription Opioid Abuse Epidemic” written by James Hupp appears in the 2016 Journal of Oral and Maxilofacial Surgery (vol. 74, pp. 1291-1293). The article describes the current challenges oral and maxilofacial surgeons are facing when it comes to prescribing opioids. This is because regulators and politicians are getting involved due to their perception of an opioid abuse problem. He mentions that Congress is considering legislation to address prescription drug addiction problems. The author wants surgeons to remember that there are legitimate reasons for giving patients who have had oral surgery such as wisdom tooth extractions an opioid medication.  Pain that interferes with a patient’s usual routines, their ability to consume enough fluids and calories, or their ability to sleep often requires a narcotic until the pain subsidizes. As such these patients should be prescribed opioids … Read more

Can Playing Baseball in Youth Lead to Better Surgeons?

by

An interesting article by Thomas Dodson titled “Everything I Ever Needed to Know About Oral and Maxillofacial Surgery, I Learned Playing Baseball” appears in the 2016 Journal of Oral and Maxillofacial Surgery (vol. 74, pp. 1709-1710). In the article the author tries to tie in how the game of baseball can teach oral and maxillofacial surgeons much of what they need to know. The author opens by talking about how he is saddened by the lost of Dr. William Harrison Bell who was a prominent surgeon in the field. He then explains that himself and the doctor who passed were both very big into baseball as youths. Dr. Dodson played first base in college and Dr. Bell was a minor league player. Dr. Dodson said that all the doctors he has worked with at various institutions all have been enthusiastic about baseball. He wonders if … Read more