Wisdom Teeth

AAOMS Issues New Position Paper on Medication-related Osteonecrosis of the Jaw

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Earlier in 2014, the American Association of Oral and Maxillofacial Surgeons issued a new position paper on Medication related Osteonecrosis of the Jaw (MRONJ) see http://www.aaoms.org/docs/position_papers/mronj_position_paper.pdf?pdf=MRONJ-Position-Paper. The condition in the past has been called Bisphosphonate-related Osteonecrosis of the Jaw but both antiresorptive and antiangiogenic therapies are associated with it so the name has been updated. MRONJ appears as non-healing exposed bone in the mouth and may affect patients undergoing intravenous cancer-related therapy or those treated with oral or IV bisphosphonates for osteoporosis. The paper states that patients may be considered to have MRONJ if the following characteristics are present: Current or previous treatment with antiresorptive or antiangiogenic agents; Exposed bone or bone that can be probed through an intraoral or extraoral fistula(e) in the maxillofacial region that has persisted for more than eight weeks; No history of radiation therapy to … Read more

Considerations For the Cost of Wisdom Teeth

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In a recent post, I discussed the cost of wisdom teeth management based on an article that appeared earlier this year in the Journal of Oral and Maxillofacial Surgery (see https://blog.teethremoval.com/the-costs-of-third-molar-wisdom-teeth-management/) Another article discussing wisdom teeth costs also appeared in the Journal of Oral and Maxillofacial Surgery in 2012 (see https://blog.teethremoval.com/the-costs-associated-with-third-molars-wisdom-teeth/). In both articles the authors conclude the costs of non-operative management of asymptomatic, disease-free, wisdom teeth exceeds the cost of operative management. I take issue with their conclusions as I believe they make too many simplifications in their analysis. I argue that the authors are ignoring the real risks of having wisdom teeth extracted that are not going to likely occur with non-operative management. Removing wisdom teeth has complications that can result. Some of these can be serious, permanent, and lasting, and cause considerable cost to both the patient … Read more

The Costs of Third Molar (Wisdom Teeth) Management

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I have previously commented on the costs associated with wisdom teeth in a 2013 blog post that was based on a 2012 article appearing in the Journal of Oral and Maxillofacial Surgery (see https://blog.teethremoval.com/the-costs-associated-with-third-molars-wisdom-teeth/). More recently, another article discussing the costs of wisdom teeth has appeared in the 2014 Journal of Oral and Maxillofacial Surgery titled “The Cost of Third Molar Management” written by Gino Inverso, Ronald Heard, and Bonnie L. Padwa (issue 72, pp. 1038-1039). This article takes the position that most previous studies focused on discussing wisdom teeth costs when taking the position from the cost of billing to private insurance companies. Their article attempts to use the true cost which they feel should help promote discussion of the topic of retaining or removing healthy disease free wisdom teeth and possibly increase access to care. In their analysis they determine the … Read more

The Culture of Safety in Oral and Maxilofacial Surgery

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Previously in a post over at https://blog.teethremoval.com/upcoming-changes-to-joms-and-aaoms-in-2014/, I discussed how the Journal of Oral and Maxillofacial Surgery is introducing a new perspectives section which “…will offer essays written on topics of interest to our specialty, including health policy, clinical controversies, and education and research matters, as examples.” On of the first perspectives section is written by Suzanne Morse Buhrow and titled “Promoting a Culture of Safety in Oral and Maxillofacial Surgery: The Time Is Now!” in the February 2014 Journal of Oral and Maxilofacial Surgery, pp. 239-240. The article opens by discussing the origins of the patient safety movement in the 1980s after the Institute of Medicine said 98,000 patients will die and 1.5 million will be injured every year from preventable medical errors in the United States. The article mentions how the National Practitioner Data Bank in the U.S. … Read more

How Evolution Sold Us Short As it Relates to Wisdom Teeth

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I came across an interesting article titled “‘Not tonight, I have toothache’: how evolution sold us short” published in February 16, 2013, in the Times in London and written by Hannah Devlin. The article talks about evolution and how it relates to wisdom teeth, which is a topic I don’t usually bring up on this site/blog since it is controversial. The idea goes that wisdom teeth were important for our ancestors because their diets consisted of a lot of tough and chewy foods. As their other teeth wore down, the third molars, played an important back up role as additional teeth to use. In addition, the idea is that as humans evolved their brains became larger and their laws became smaller leaving less room available for teeth to grow. Earlier hominids (our ancestors) had very large back teeth in long … Read more