pediatric

Should we Remove Wisdom Teeth Before Bone Disease Therapy?

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An interesting article titled “Pediatric-Antiresorptive Use: Should We Intervene on Third Molars Early?” written by Michael J. Cimba and et al. appears in the Journal of Oral and Maxillofacial Surgery (vol. 79, pp. 1817−1818, 2021). The article seeks to address if oral surgeons should consider preventatively extracting wisdom teeth in children before they start bone disease therapy to prevent jawbone destruction. In the article the authors discuss how removing wisdom teeth that have not yet fully developed in children before they begin antiresorptive therapies may prevent them from developing medication-related osteonecrosis of the jaw (MRONJ). MRONJ, a progressive death of the jawbone, is a side effect of antiresorptive therapy such as bisphosphonates and denosumab, which are drugs used to treat bone (osseous) diseases and cancer-related conditions. It is well known that dental extractions like removing wisdom teeth can increase the risk … Read more

Is it Safe for Children to Receive Sedation/Anesthesia from an Oral Surgeon or Dentist using a Single Provider/Operator Model?

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Recently on this site there has been much discussion on updated guidelines put out by various groups that argue that children having deep sedation and anesthesia are not safely being served by dentists and oral surgeons using a single provider/operator model. Instead these guidelines call for a multi-provider model where the person doing the dental work or oral surgery and the person administering and monitoring the sedation/anesthesia are two separate individuals. See the posts AAOMS Pushes Back on Anesthesia Guidelines for Pediatric Patients and Updated Sedation Guidelines in Dentistry for Children for additional details. Some of the individuals leading the charge against the current anesthesia delivery model for children have published a new opinion piece titled “The Single-Clinician–Operator/Anesthetist Model for Dental Deep Sedation/Anesthesia: A Major Safety Issue for Children” published online in JAMA Pediatrics on Oct. 28, 2019 (written by … Read more

The Image Gently Campaign in Dentistry

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If you keep abreast at all with radiation exposure from medical imaging, you may have heard of the Image Wisely campaign. The Imagely Wisely Campaign was designed to have people aware of the fact that certain medical imaging tests such as CT exams are sometimes over used and do not have to be used in certain instances. The goal is to reduce radiation exposure to patients while still providing good medical care, see http://www.imagewisely.org/. The Image Gently campaign is designed to provide information to parents and others to help reduce exposure to radiation for children, see http://imagegently.org/, and has been around since 2007. The campaign is supported by the Alliance for Radiation Safety in Pediatric Imaging, which is a coalition of healthcare organizations dedicated to providing safe and high-quality pediatric imaging. Recently, it has been announced that a new Image Gently campaign in dentistry … Read more