Do Oral Surgeons Prescribe Too Many Narcotics for use after Wisdom Teeth Removal?

A new article published in the Journal of Oral and Maxillofacial Surgery is titled ” Narcotic Prescribing Habits and Other Methods of Pain Control by Oral and Maxillofacial Surgeons After Impacted Third Molar Removal,” by Ibrahim Mutlu, A. Omar Abubaker, and Daniel M. Laskin (vol. 71, pp. 1500-1503, 2013). The article explores the issue of whether or not oral surgeons regularly prescribe more than an adequate amount of narcotic pain killers to young adults after their wisdom teeth extraction. It has been believed by some that the narcotics given by oral surgeons for wisdom teeth removal can be a source of using narcotics for non-medical uses. In this article a 8 question survey was sent to 100 randomly selected oral and maxillofacial surgeon members of the American Association of Oral and Maxillofacial Surgeon (AAOMS). The questions were related to whether … Read more

Can a Persistent Headache be Caused by Sinus Problems?

I came across an interesting article that appeared over a year ago in the Washington Post. The article is titled “A man’s persistent headache proves hard to diagnose and harder to treat,” by Sandra G. Boodman, and published on March 19, 2012. Article Link: http://articles.washingtonpost.com/2012-03-19/national/35448791_1_headache-sinus-pain-relievers The article discusses a 41 year old man who developed a constant headache in November of 2008. Over the course of many months the man consulted many neurologists, ear nose and throat doctors, ophthalmologist, and others but none could explain what was causing him the headache. The man is quoted as saying “I’d been chasing this for more than six months. No one could tell me what it was. I just remember thinking, ‘How am I going to be able to function if it never goes away?” Over the course of the treatment the man … Read more

Potential Risks of Surgery for Wisdom Teeth (Third Molars)

M. Anthony Pogrel in his article “What Are the Risks of Operative Intervention?” in the Journal of Oral and Maxilofacial Surgery vol. 70, pp. 33-36, 2012, suppl. 1, goes into complications associated with removing impacted wisdom teeth (third molars). I have previously explored this topic in detail over at http://www.teethremoval.com/complications.html. Although I did a poor job of distinguishing actual complications from negligence. In the article, Pogrel describes how studies have indicated that around 10% (1 in 10) of people undergoing removal of third molars may suffer from a complication. However, most of these complications are mild and will completely resolve in time. Pogrel states “Complications from M3 removal can be divided into 2 groups: those that are short-lived and self limiting, including bleeding, inflammatory complications such as surgical site infection and alveolar osteitis, or “dry socket,” drug reactions, displaced crowns … Read more

Association Between Partially Erupted Mandibular Third Molar and Caries in Distal Second Molar

An interesting article titled “Association between the presence of a partially erupted mandibular third molar and the existence of caries in the distal of the second molars,” appears in the International Journal of Oral and Maxilofacial Surgery by S. G. M. Falci and et. al. (October 2012, pp. 1270-1274). The article mentions how previous studies have shown that caries on the mandibular second molar due to the presence of partially erupted third molars has varied between 7% and 32%. The article criticizes prior work where studies based their prevalence data on panoramic radiographs which is not as good as periapical radiographs when diagnosing caries. The authors state “The lack of sample characterization, the absence of sample calculation, the deficient or inadequate statistical analysis and the absence of a description of the eligibility criteria, discredits the scientific evidence of these previous … Read more

The Costs Associated with Third Molars (Wisdom Teeth)

An interesting articled by George M. Koumaras titled “What Costs Are Associated With the Management of Third Molars?” appears in the 2012 J Oral Maxillofac Surg vol. 70, pp. 8-10, supp. 1. The article attempts to look at the costs associated with asymptomatic, disease-free, third molars (wisdom teeth). Three scenarios were explored by the author: scenario 1 (nonoperative management): retention of asymptomatic, disease-free third molars and monitoring for 20 years from age 18 to 38 years scenario 2 (operative management): removal of 2 asymptomatic, disease-free, bony impacted third molars for 18-year-old patients using general anesthesia (30 minutes) in an office-based ambulatory setting scenario 3 (failure of nonoperative management): removal of 1 previously asymptomatic, disease-free, bony impacted third molar after 10 years of follow-up in a now 28-year-old patient using general anesthesia (30 minutes) in an office-based ambulatory setting.” The author … Read more