Wisdom Teeth

Practice Based Wisdom Teeth Removal Study

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An interesting article titled “Recommendations for Third Molar Removal: A Practice-Based Cohort Study,” appears in the April 2014, issue of the American Journal of Public Health (Vol. 104, No. 4, pp. 728-734), by Joana Cunha-Cruz and et. al. In the article a dental practice based research network Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT) is used. A total of 50 general dentists enrolled patients from May 2009 to September 2010.  In the study a total of 797 patients who had wisdom teeth (third molar) recommendations from their general dentist were used who were aged 16 to 22. However, the patients were asked to take a survey every 8 months and then a clinical visit 24 months later.  From this sample of 797 patients only 516 completed at least one follow up questionnaire. In the study the general dentists reported that … Read more

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