How dentists can navigate ethical treatment decisions for patients

An interesting article titled “How to manage the principal-agent problem in dentistry,” appears in the June 2022 edition of the Journal of the American Dental Association (JADA) written by Ben Balev (no. 153, issue 6, pp. 588-589). The article discusses the principal-agent problem, in which the dentist operates as the agent for the patient who is the principal and there is an imbalance of power between the patient and the dentist in decision making. In the dentist-patient relationship, the dentist has specialized knowledge that the patient lacks, and the patient seeks to make up for their lack of knowledge by having the dentist help in oral health decisions. Such a relationship requires that the patient trusts that the dentist functions in their best interest. However, sometime the patient questions the dentists motives behind their treament recommendations. The patient may wonder … Read more

Surgery Free Wisdom Tooth Bud Ablation Treatment To One Day Replace Surgery?

An interesting article titled “Fully Guided Tooth Bud Ablation in Pigs Results in Complete Tooth Bud Removal and Molar Agenesis” appears in the Journal of Oral and Maxillofacial Surgery written by Leigh E. Colby and David P. Watson, Vol. 81, Issue 4, pp. 456-466, Apr. 2023, Published Dec. 16, 2022. The article seems to be a follow-up to a prior article discussed on this site in the post “Tooth bud abalation of wisdom teeth may be alternative to surgery in the future“. That study had shown that fully guided microwave tooth bud ablation (3TBA) could be used to successfully remove wisdom tooth tooth buds without damaging surrounding tissues in a study with 5 pigs. The most recent study used a 28-day longitudinal characterization study to determine if healing response following fully guided microwave ablation of tooth buds in pigs would result in … Read more

What is the Estimated Amount of Wisdom Teeth Extractions in the US

An interesting article titled “Estimated Cumulative Incidence of Wisdom Tooth Extractions in Privately Insured US Patients,” written by Alan R. Schroeder and et. al. appears in Frontiers in Dental Medicine (July 2022, vol. 3, article 937165). The article sought to determine the cumulative incidence and predictors of wisdom teeth extractions in the US. The article was motived by some of the controversy around wisdom teeth extractions and to better provide frequency estimates of the procedure to help inform future quality improvement initiatives and/or clinical trials. The authors used a national dental insurance claims database of privately insured patients (IBM MarketScan Dental Database), to help estimate the incidence of wisdom teeth extractions in the US and to determine variation by sex and geographic region. The authors included all patients in the database for their study who were under 60 years of … Read more

What Dentists Should Say to Patients when Something Doesn’t Go Right

Unfortunately dentists and oral surgeons don’t always have all procedures go as planned for their patients. For example, when it comes to wisdom tooth surgery, it is possible for the wrong set of wisdom teeth to be removed as is discussed on the wisdom teeth complications page, see https://www.teethremoval.com/complications.html. Since procedures don’t always go as planned, on this site before guidance for patients who want to be very defensive has been provided, see the post The Defensive Patients Guide to Wisdom Teeth Removal. While patients can sometimes be bad actors and deny that certain information was provided to them prior to a procedure (see the post Patient Recall During Informed Consent for Wisdom Teeth Surgery), dentists and oral surgeons also can behavior badly such as by telling patient’s after their procedure that their condition that resulted could not have possibly … Read more

Patients Wisdom Teeth Extraction Results in Reactive Arthritis

An interesting article titled “Reactive Arthritis Resulting From Postoperative Complications of Third Molar Extraction: A Case Report,” appears in Cureus in August 23, 2022, written by Lauren Maytin and Jeffrey Morrison (vol. 14, no. 8, pp. e28325). The article presents a case report of a 23 year old woman who develped reactive arthritis after wisdom teeth extraction. In the article the authors discuss a 23 year old woman who had a history of lower back and joint pain but developed more severe of symptoms of bilateral shoulder pain, decreased range of motion in her left shoulder, and worsening lower back after having an infected infected wisdom tooth extracted. She was diagnosed with rheumatoid arthritis and and was prescribed adalimumab. Her laboratory results showed elevated indicators of inflammatory activity that were positive for HLA-B27. The woman presented to two weeks after wisdom … Read more