Pain

Updates on Anesthesia Provided by Oral and Maxillofacial Surgeons

by

Recently, it has come to my attention that the American Association of Oral and Maxillofacial Surgeons (AAOMS) has released a new white paper titled “Office-Based Anesthesia Provided by the Oral and Maxillofacial Surgeon,” in 2013, located over at http://www.aaoms.org/docs/papers/advocacy_office_based_anesthesia.pdf. This data contains some important data from the OMS National Insurance Company (OMSNIC) which to my knowledge had been previously closed. This data is Anesthesia Morbidity and Mortality Data from 2000 to 2010  for a total of 29,975,459 in-office anesthetics (conscious sedation, deep sedation and general anesthesia) provided by oral and maxillofacial surgeons in their offices. It was found from this data that the ratio of office fatalities/brain damage per anesthetics administered is 1 to 365,534.  I had long wondered what this data showed as I have previously looked at numerous studies attempting to determine how many deaths occur when anesthesia … Read more

Can a Persistent Headache be Caused by Sinus Problems?

by

I came across an interesting article that appeared over a year ago in the Washington Post. The article is titled “A man’s persistent headache proves hard to diagnose and harder to treat,” by Sandra G. Boodman, and published on March 19, 2012. Article Link: http://articles.washingtonpost.com/2012-03-19/national/35448791_1_headache-sinus-pain-relievers The article discusses a 41 year old man who developed a constant headache in November of 2008. Over the course of many months the man consulted many neurologists, ear nose and throat doctors, ophthalmologist, and others but none could explain what was causing him the headache. The man is quoted as saying “I’d been chasing this for more than six months. No one could tell me what it was. I just remember thinking, ‘How am I going to be able to function if it never goes away?” Over the course of the treatment the man … Read more

Electric Stimulation of Brain Releases Powerful Painkiller

by

Researchers have been exploring delivering electricity through sensors on the skulls of chronic migraine patients and have found a decrease in the intensity of pain of their headaches. A recent study published in Frontiers in Psychiatry has shown that when electricity is sent to certain regions in the brain of a patient with chronic, severe facial pain it releases an opiate-like substance and powerful painkiller. In the study, researchers administered a radiotracer that reached important brain areas in a patient with trigeminal neuropathic pain. They then applied electrodes and electrically stimulated the skull right above the motor cortex  for 20 minutes during a PET scan which is known as transcranial direct current stimulation (tDCS). The radiotracer was designed to measure the local brain release of mu-opioid, a natural substance that alters pain perception. The researchers argue that this is the … Read more

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

by

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

Should you use Sutures when having Wisdom Teeth Out?

by

A study titled “A comparative study of the effect of suture-less and multiple suture techniques on inflammatory complications following third molar surgery” appears in the 2012 (in press) International Journal of Oral and Maxillofacial Surgry by O.D. Osunde, R.A. Adebola, and B. D. Saheeb. The study in Nigeria included 80 patients between the ages of 18 and 30 who had a mandibular third molar extracted. These patients were randomized into 2 treatment groups A: (suture-less – no sitches) and B: multiple sutures. The operation time was found to be roughly 3 minutes longer in the sutures group (statistically significant). In addition, the suture-less group experienced less pain, swelling, and trismus on post-operative days 1 and 2 (statistically significant). In the article the authors state: “The suture-less technique is cheap, saves operative time, minimizes manipulation of soft tissue and hence causes … Read more