surgery

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

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

Reconsideration of decision making for third molar extraction

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An article recently appeared in the Journal of the Korean Association of Oral and Maxillofacial Surgery titled “Reconsideration of decision making for third molar extraction, “(vol. 37, pages  343-348, 2011) by Wonse Park and et al. I am unable to read the article since it is in Korean but the abstract is in English. The introduction of the article states “Third molar extraction is one of the most common procedures in oral and maxillofacial surgery. The impacted third molar causes many pathological conditions, such as pericoronitis, caries, periodontitis, resorption of adjacent teeth, and cyst or tumors associated with impacted teeth. Extraction is often considered the treatment of choice for impacted lower third molars. On the other hand, imprudent extraction of deeply impacted third molars can cause permanent complications, such as inferior alveolar nerve damage. Therefore, guidelines for the extraction of … Read more

Using Computed Tomograph (CT) To Lower the Incidence of Wisdom Teeth Removal Nerve Injuries

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A question that everyone who has wisdom teeth wants to know these days is the following: “If you use Computed Tomography (CT) can it lower the risk of developing a nerve injury from having wisdom teeth removed?” Three authors from Spain (Sanmarti-Garcia, Valmaseda0-Castellon, Gay-Escoda) recently conducted a study asking this question titled “Does Computed Tomography Prevent Inferior Alveolar Nerve Injuries Caused by Lower Third Molar Removal?” appearing in the Journal of Oral and Maxillofacial Surgery (vol 70, pages 5-11, 2012). The issue is as stated by the authors is that “panoramic radiography alone cannot identify the buccolingual position of the mandibular canal and the 3M roots.” Computed tomography (CT) is able to show this information. Even so an estimated 40% of cases show superposition of the roots and the mandibular canal. Hence many of the potential CTs performed may potentially … Read more

Potential Alternatives to the Current Medico-Legal System in the United States

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On my site I discuss numerous issues with the current legal system and how this relates to the medical system with a focus on third molar (wisdom teeth) removal. See http://www.teethremoval.com/legal_system_medical_malpractice, http://www.teethremoval.com/legal_standpoint.html, and http://www.teethremoval.com/dental_malpractice.html. One issue is that there are a host of different damage caps (non-economic ‘pain and suffering’ awards) in different states throughout the United States. This can sometimes limit the amount a patient can receive even if there was gross negligence by the dentist or oral surgeon. Hence this can prevent fair compensation from being awarded. Another issue with the legal system is that sometimes when patients suffer complications and problems due to negligence they will not be able to sue due to the case not being able to get a very large settlement amount. In addition, these legal cases can drag on for years and years … Read more