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Updates on Anesthesia Provided by Oral and Maxillofacial Surgeons

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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

Looking at Evidence Supporting Dental Procedures from Cochrane Systematic Reviews

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An interesting article titled “Is the Evidence Supporting Dental Procedures Strong? A Survey of Cochrane Systematic Reviews in Oral Health” by Clovis Mariano Faggion Jr. appears in J Evid Base Dent Pract, vol. 12, pp. 131-134, 2012. The article sets out to explore Cochrane systematic reviews and whether or not they provide useful information for use in dentistry. The author set out to look at the quality of evidence for Cochrane systematic reviews published in dentistry. The evidence was considered inadequate when authors described weak or insufficient evidence or when no studies were selected for the review. A total of 120 systematic reviews were looked at for 20 topics. The author did have some creative interpretation to assess the reviews. He states: “The full text of articles was, however, scrutinized to assess the risk of bias of included primary studies; methodological … Read more

Lessons from Medical litigation in oral surgery practice

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I have previously touched on, such as in the post How to Improve Your Chances to Win a Dental Malpractice Lawsuit, some of the issues surrounding medical litigation from a dental and oral surgery standpoint. In the article “Medical litigation in oral surgery practice: Lessons learned from 20 lawsuits,” by Hesham F. Marei, currently in Press at the time I have reviewed this, Journal of Forensic and Legal Medicine, 2012, an investigation into lawsuits occurring in an oral surgery setting over three years (2009-2012) in Saudi Arabia is explored. Over 100 lawsuits were looked at with 20 fitting in the inclusion criteria. Marei states: “The most common cause for litigation was oro-antral communication, followed by neurological deficit associated with the surgical removal of wisdom teeth and placement of dental implants. Bleeding after extraction was the third most common cause for … Read more

The Misbehaving Tooth Fairy

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In the article “The tooth fairy and malpractice” by Sian Ludman, Hamid Daya, Polly S Richards, and Adam Fox, in BMJ Christmas 2012, 345, e3027, a very interesting discussion is made of the tooth fairy. The article states “We are concerned that the actions of the mythical character at the root of this report must be brought to the attention of the medical community, as it seems to represent the first signs of a worrying new trend in malpractice.” The tooth fairy is widely considered to be benevolent but the authors present a disturbing report. A discussion is made of an 8 year old who presented with a foreign body in the left external auditory meatus (which showed up on a CT scan). The image is in the report. The parents of the boy discussed how three years earlier the … Read more

Dental Bibs May Harbor Oral and Skin Bacteria Even After Disinfection

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Researchers at Tufts University School of Dental Medicine and the Forsyth Institute published a study on April 2, 2013, which showed that a significant proportion of dental bib clips harbored bacteria from the patient, dental clinician, and the environment after the clips had undergone standard disinfection procedures. A dental bib clip of course is that metallic chain that wraps around your neck and holds the dental bib that the dentist gives you when you see them. The researchers found that the majority of thousands of bacteria found on bib clips were removed after the standard disinfection procedure. Even so, the researchers found that 40% of the bib clips after disinfection retained one or more aerobic bacteria which is able to grow and live in oxygenated environments. Furthermore, the researchers found that 70% of bib clips tested after disinfection retained one … Read more