Assessing the Impact of Three Day Opioids Limits for Dentists

An interesting article titled “Opioid Formulary Edit’s Impact on Commercial Dental Prescribers” was presented on July 23, 2021, at the virtual session of the 2021 International Association for Dental Research (IADR)/AADR/CADR General Session written by David Hamlin and et al. The research set to investigate the impact the insurance company Cigna had when it implemented its three-day quantity limit on dental opioid prescriptions. Insurance companies limiting new opioid prescriptions for dentists to three days (or another time duration) has been discussed on this site before in the post Insurance Companies Limiting Access to Opioids After Wisdom Teeth Surgery. The authors speculated that by limiting opioid prescriptions to three day there would be year-over-year reductions in prescriptions greater than three days and reductions in the average total metric quantity per prescription. In the study, the authors looked at the claims of … Read more

Recommendations on Accidental Displacement of a Wisdom Tooth

One of the complications associated with wisdom teeth removal is the accidental displacement of the wisdom tooth. This has been discussed in the post Computer Assisted Retrieval of Accidentally Displaced Wisdom Teeth and as a complication over at http://www.teethremoval.com/complications.html. There are many places in the human body a wisdom tooth can end up in accidentally during surgery such as the maxillary sinus, submandibular space, sublingual space, infratemporal fossa, lateral pharyngeal space, and pterygomandibular space. In an article titled “Accidental displacement of third molars; report of three cases, review of literature and treatment recommendation” written by Anand and Patel appearing in Oral Surgery in 2013 (vol. 6, pp. 2-8) a discussion is made of three cases of displacement of a wisdom tooth during tooth extraction along with treatment recommendations. In the article the authors describe the most common sites of displacement … Read more

Tooth bud abalation of wisdom teeth may be alternative to surgery in the future

An interesting article titled “Fully Guided Third Molar Tooth Bud Ablation in Pigs,” appears in the Journal of Oral and Maxillofacial Surgery written by Leigh E. Colby (2022, pp. 1-12). The article describes the investigation of ablated wisdom tooth buds in pigs which may one day serve as an alternative to surgical extraction. In the study the author conducted a mandibular split-mouth animal pig study that compared right lower wisdom tooth with left unablated wisdom tooth buds. The left unablated tooth buds were used as the control group. The author stated that pigs were chosen as their wisdom tooth bud development resembles that of humans. Further pigs that were 20 weeks old were chosen as they have wisdom tooth buds that are similar in dimension to humans. A total of 5 female pigs were used that were acquired in Oregon. … Read more

Combining ibuprofen and acetaminophen for wisdom teeth surgery pain management

Before on this site the hazards of opioids prescribed for surgeries like wisdom teeth extraction has been discussed. Instead of taking an opioid like Vicodin which contains hydrocodone or another opioid that contains oxycodone an alternative patients may have if their oral surgeon is willing is to take a combination of ibuprofen and acetaminophen. This combination has been discussed in many articles on the past on this site such as Reducing Opioids in Oral and Maxillofacial Surgery, New Research Being Conducted at Rutgers for Opioid Alternatives Could Lead to Less Potential Drug Abuse for those Having Wisdom Teeth Surgery, and Oral and Maxillofacial Surgeons Current Perspectives on Opioid Prescribing. Patients may have questions about the right dosage level, there side effects, and if they work as well as opioids. According to a white paper by the American Association of Oral … Read more

Using Bupivacaine with Wisdom Teeth Removal Results in Less Opioids Prescribed

An interesting article titled “A Retrospective Cross-Sectional Study of the Effect of Liposomal Bupivacaine on Postoperative Opioid Prescribing After Third Molar Extraction,” written by Stuart E. Lieblich and et al. appears in the Journal of Oral and Maxillofacial Surgery (vol. 79, pp. 1401-1408, 2021). The study seeks to explore if patients who have lower wisdom teeth removed using liposomal bupivacaine need less opioids than those wo do not have liposomal bupivacaine. In the study the authors performed a retrospective study of patients who had undergone wisdom teeth extraction at 2 outpatient oral surgery centers in the United States. Patients had to have been at least 18 years of age and undergoing an elective wisdom tooth removal with 1 partial bony or full bony lower impacted wisdom tooth. A total of 600 patients who underwent wisdom teeth extracted were included in … Read more