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

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

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

Perioperative Information for Third Molar (Wisdom Teeth) Removal

A recent study titled “An Evaluation of Patients’ Knowledge About Perioperative Information for Third Molar Removal,” appears in the Journal of Oral and Maxillofacial Surgery (vol. 70, pages 12 – 18, 2012). The study attempts to look at what patients know about third molar (wisdom teeth) removal before having surgery performed. The study was conducted by authors in Brazil and Kentucky (United States). The study explains on being nervous and anxious before having wisdom teeth removed can actually cause a longer surgery, more potential swelling, and even more pain. Hence there is incentive for the surgeon and the surgical team to help produce a calming environment for patients to help reduce anxiety which can lead to potentially better outcomes. The study had 67 patients which included 43 female and 24 males who had 1 or more wisdom tooth removed. The … Read more

Advocacy White Paper on Third Molar Surgery by AAOMS

Recently the American Association of Oral & Maxillofacial Surgeons (AAOMS) issue a Press Release located over at http://www.prnewswire.com/news-releases/aaoms-white-paper-discusses-why-when-and-how-to-treat-third-molar-teeth-135889358.html In the conclusion of the press release it states “The AAOMS encourages patients and their families to talk to their general dentist, orthodontist or family physician to determine whether third molar surgery is indicated. If a decision is made to retain these teeth, regular dental check-ups and good dental hygiene to control or prevent periodontal disease are essential.” The press release discusses a recent Advocacy White Paper released on Third Molar Surgery. This is located at http://www.aaoms.org/docs/evidence_based_third_molar_surgery.pdf I think the this recent White Paper issued on November 10, 2011, is well worth the read for anyone considering having elective healthy wisdom teeth surgery performed. The paper mentions some of the recent controversy of the medical necessity of removing erupted and impacted third molars. Numerous references to … Read more

What to Do about the Fourth Molar: Similar Management Strategies as the Third Molar aka Wisdom Tooth?

So wisdom teeth are also known as third molars but did you know that there are also fourth molars in a small subset of patients? A recent study was performed by the United States at an Air Base in Japan which is currently in press to appear in the Journal of Oral and Maxillofacial Surgery titeld Prevalence and Management of Fourth Molars: A Retrospective Study and Literature Review by Khurram M. Shahzad and Lawrence E. Roth, 2011. In the study conducted 409 patients were referred for a third molar (wisdom teeth) consultation. Two of 227 white patients (0.9%) had a fourth molar and 6 of 94 black patients (6.4%) had a fourth molar. One of the other 84 patients (1.2%) also had a fourth molar. Of these patients with a fourth molar 5 out of 9 (55%) had only 1 … Read more