Using Dexmedetomidine For Wisdom Teeth Surgery

An interesting article titled “Sedation Protocol Using Dexmedetomidine for Third Molar Extraction” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Dae-Seung Ryu and et. al. (vol. 74, pp. 926.e1-926.e7). The article seems to determine a sedation protocol for dexmedetomidine. The authors state that IV sedation is often given in cases of wisdom teeth surgery with midazolam being a medication commonly used. When midazolam is combined with opioids it can cause respiratory depression. Dexmedetomidine is an alpa2-agonist acting on adrenoceptors in many tissues, including those in the nervous, cardiovascular, and respiratory systems. Compared with midazolam, the major advantage of dexmedetomidine is its minimal effect on the respiratory system. It also produces an analgesic effect which can help alleviate the sensation of pain after tooth extraction. The authors set out to study the pain, patient satisfaction, sedation depth, and adverse effects after wisdom teeth extraction using dexmedetomidine and to compare IV and intranasal (IN) routes of administration. The … Read more

Can Science Solve Our Problems?

An interesting article titled “Science and Conscience” appears in the 2015 Journal of Oral and Maxilofacial Surgery written by Thomas Dodson (vol. 73, pp. 2255-2256). The article opens by discussing a study by the NIH seeking to explore the differences in people with a systolic blood pressure of 140 mm Hg versus that of 120 mm Hg. The study was aborted with a year left in its duration. The study concluded achieving a target systolic blood pressure of 120 mm Hg reduced cardiovascular events by almost 33% and death by almost 25% compared with a group with a target systolic pressure of 140 mm Hg. The authors question why such a study was ever needed to be done because it seems so intuitive but later explains that our society today relies on science to achieve it’s high standards. The author then goes on to discuss how there … Read more

Management of Wisdom Teeth 2016 AAOMS Updates

The American Association of Oral and Maxilofacial Surgeons (AAOMS) has some additional information they appear to have added more recently to their third molar research news section. For those considering how to best manage their wisdom teeth they should take a look at http://www.aaoms.org/docs/govt_affairs/advocacy_white_papers/management_third_molar_white_paper.pdf and http://www.aaoms.org/images/uploads/pdfs/management_third_molar_supporting_information.pdf. The first document describes what many different oral surgeons groups including AAOMS currently suggest for managing wisdom teeth. The article says “There are a variety of recognized management choices for third molars, including removal, partial removal (coronectomy), retention with active clinical and radiographic surveillance, surgical exposure, tooth repositioning, transplantation, surgical periodontics, and marsupialization of associated soft tissue pathology with observation and possible secondary treatment.” The article says that a decision to remove or retain healthy asymptomatic wisdom teeth should be made before a patient is 30. The position statement is said “Predicated on the … Read more

Complications Associated with Coronectomy

An interesting article titled “What Are the Types and Frequencies of Complications Associated With Mandibular Third Molar Coronectomy? A Follow-Up Study,” appears in the 2015 Journal of Oral and Maxillofacial Surgery (vol. 73, pp. 1246-1253) and written by Giuseppe Monaco. The article explores the likelyhood of complications occuring with coronectomy procedures. Coronectomy is an alternative surgical procedure to extract wisdom teeth with roots that are close to the mandibular canal. The article describes a research study  to determine whether coronectomy decreased neurologic damage in cases of mandibular third molars in close proximity to the inferior alveolar nerve. The study looked at 94 healthy patients with a mean age of ~30 who had 116 mandibular third molars (wisdom teeth) treated with coronectomy. A total of 28 patients dropped out of the study during the 3 year follow up period. Of the … Read more

Anxiety in Dental Patients Before and After Tooth Extraction

An interesting article titled “Assessment of general pre and post operative anxiety in patients undergoing tooth extraction a prospective study,” appears in the British Journal of Oral and Maxillofacial Surgery and written by Pia López-Jornet and et al. (vol. 52, pp. 18-23, 2014). The article sought to explore the amount of anxiety and fear before, immediately after, and one week after dental extraction. The researchers included 70 patients in their study. It is known that fear and anxiety in dentistry is usually associated with poor oral health and poor oral health related quality of life. Some studies have shown that those with lower socioeconomic status and with less education have more anxiety but others have shown those with more education have more anxiety. The researchers believe that oral surgery is stressful for patients and that anxiety fluctuates over time. They feel dental anxiety can be assessed with self-reported … Read more