third molar

Monitoring the Periodontal Status of Wisdom Teeth

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An interesting article titled “Monitoring for Periodontal Inflammatory Disease in the Third Molar Region,” appears in the April 2015, issue of the Journal of Oral and Maxilofacial Surgery written by Brent A. Golden and et. al. (vol. 73, issue 4). The study looked at participants who had asymptomatic wisdom teeth and sought to assess the periodontal status of those wisdom teeth at 2 year intervals for 6 years. The participants in the study were taken to have healthy periodontal status of their wisdom teeth if the probing depths were less than 4 mm. A total of 129 such patients were included in the study. In actuality the study participants were a subsample of another larger study were patients had 4 asymptomatic wisdom teeth. The subsample included all participants with a healthy periodontal status (all probing depths less than 4 mm) … Read more

Improving Value: Prespectives from Oral Surgeons

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An interesting editorial appears in the 2014, issue of the Journal of Oral and Maxillofacial Surgery titled “The Value of Improving Value,” by James Hupp (pp. 843-845, issue 72). In this Dr. Hupp presents a formula for patient value Value = A(Q + PS)/C A = appropriateness, Q = quality, PS = patient satisfaction, and C = costs The author states “First, one can improve outcomes while keeping costs the same. Second, one can decrease costs while keeping outcomes the same. Or third, both outcomes and costs increase, but outcomes per unit of cost improve.” In the article the author discusses how in the past, value in health care was really just about cost cutting. Clinical outcomes were not really taken into account. Now that health care outcomes are being considered, physicians need to find ways to measure value using the … Read more

Differing Views in Medicine and Dentistry Applied to Wisdom Teeth

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An interesting article appears in the 2014 version of the Journal of Oral and Maxillofacial Surgery titled “Asymptomatic Third Molars Under Nominalist and Essentialist Lenses,” written by V. Wallace McCarlie and Daniel L. Orr II, pp. 658-659.  The authors define two differente views: 1) essentialism and 2) nominalism and then try to apply them to the management of wisdom teeth. The authors state “Essentialism is the notion that underlying every properly defined disease is an unchanging reality causing illness. Conversely, nominalism is not concerned with underlying causes, but rather with signs and symptoms of illness.” In the article the authors mention a study which says that dentists detect rather than diagnose. The authors later say that detection implies nominalism and diagnosis implies essentialism. The authors give some downsides to both points of view. For example, they say essentialism is less … Read more

Should the NICE Guidelines for Management of Wisdom Teeth (Third Molars) be Reevaulated?

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An article titled “Changes in Demographics of Patients Undergoing Third Molar Surgery in a Hospital Setting Between 1994 and 2012 and the Influence of the National Institute for Health and Care Excellence Guidelines,” written by Vahe Petrosyan and Phillip Ameerally appears in the February 2014 issue of the Journal of Oral and Maxillofacial Surgery, pp. 254-258. The article discusses how National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) were published around 2000 recommending against prophylactic removal of wisdom teeth. This led to a reduction in surgeries performed. In the article the authors question whether or not the NICE guidelines on wisdom teeth should be updated. They mentioned a 2009 study which said 27% of previously symptom free wisdom teeth can become symptomatic after 1 year, especially those that are distoangularly impacted. In the … Read more

The Costs of Third Molar (Wisdom Teeth) Management

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I have previously commented on the costs associated with wisdom teeth in a 2013 blog post that was based on a 2012 article appearing in the Journal of Oral and Maxillofacial Surgery (see https://blog.teethremoval.com/the-costs-associated-with-third-molars-wisdom-teeth/). More recently, another article discussing the costs of wisdom teeth has appeared in the 2014 Journal of Oral and Maxillofacial Surgery titled “The Cost of Third Molar Management” written by Gino Inverso, Ronald Heard, and Bonnie L. Padwa (issue 72, pp. 1038-1039). This article takes the position that most previous studies focused on discussing wisdom teeth costs when taking the position from the cost of billing to private insurance companies. Their article attempts to use the true cost which they feel should help promote discussion of the topic of retaining or removing healthy disease free wisdom teeth and possibly increase access to care. In their analysis they determine the … Read more