oral surgery Archives - The Wealthy Dentist

Dentist Leaves Drill Bit in Patient’s Sinus

Dentist drill bit left in patient's sinusA Florida woman recently had an inch-long dentist drill bit burr removed from her sinus after nearly a year.

When an oral surgeon removed two decayed teeth from the 35-year-old woman’s mouth, he apparently did not notice that he had lost the drill bit.

The woman experienced pain, sinus infections, dizziness, numbness and other symptoms. Her lawyer claims the oral surgeon dismissed her concerns out of hand. He did not x-ray her, which would have shown the burr.

She ended up at a hospital for treatment. Not knowing she had a piece of metal stuck in her head, doctors there gave her a magnetic scan – which caused the metal to move, causing severe pain. (Luckily, pain was all it caused… the fact is, the magnetic scan could have killed her.)

Eleven months after the drill burr got trapped in her sinus, it was surgically removed. It remains to be seen whether she will have lasting health problems; nickel poisoning is a concern.

Not surprisingly, she hired a lawyer and filed suit. The dentist (no longer practicing at that office) declined to comment.

Read more: Dentist’s drill bit left in head for 11 months, lawsuit says

Dental Stem Cells Hidden Inside Wisdom Teeth

Stem cells in wisdom teethStem cells and dentistry are becoming linked in all kinds of new ways. The latest is news that wisdom teeth can be a source of stem cells.

The wisdom teeth don’t contain actual stem cells themselves, but cells inside the dental pulp can be coaxed into creating stem cells.

Since wisdom tooth removal is such a common procedure, and one performed in a sterilized environment, it’s a great opportunity. The tissue removed during the wisdom tooth extraction can be frozen and stored for later use.

What that “later use” might be isn’t clear yet, but it seems likely that new stem cell therapies will continue to be introduced. Recent headlines heralded that fact that dental implants may soon include stem cells.

Are there any dental marketing ramifications? Well, if you remove wisdom teeth, you may find you can offer an additional service at some point in the future!

Read more: Wisdom teeth a source of stem cells and Induction of Pluripotent Stem Cells from Human Third Molar Mesenchymal Stromal Cells

Wisdom Tooth Dentists Know Their Limits (video)

Wisdom teeth referralsHalf of dentists refer out 80% or more of wisdom teeth extractions, our survey found.

“That’s what oral surgeons are for!” said a dentist who refers out all removals.

“Better them than me!” agreed a dentist who refers 60-80%. “I actually have an oral surgeon come into the office and do impacted wisdom teeth with oral/nitrous sedation dentistry.”

Read more: Dentists and Wisdom Tooth Extractions

Wisdom Teeth Removal Fee Analysis

wisdom teeth fees

Wisdom Teeth: specialist fees 39% higher than general practitioners.

The Wealthy Dentist conducted a survey asking dentists and specialists what their fee is for removing wisdom teeth.

We found that specialist fees are 39% higher than general practitioners.

Some dentists cited the use of sedation as a reason for the increased cost.

“The fact that sedation is used gives patients the feeling that the higher cost at the oral surgeons is worth it!” pointed out a West Virginia dentist.

But others disagreed. “In my area the GP’s fees are generally higher than the specialists because we take longer to do it,” said one California dentist. Another Colorado dentist said, “Usually our fees are about the same as the oral surgeon.”

In this survey, here’s what dentist respondents revealed:

The average cost at a general practice – $483.00
The average cost at a specialist practice – $791.00

And here are some comments:

“If it’s easy like any old extraction, I use the regular extraction fee and the reg code. There’s no “wisdom teeth extraction” code. $575.00 is as high as I go to include flapping, osseous removal, bone graft (if needed) and sutures, poat op, etc…” (New York dentist)

“Our fee depends on if it’s impacted or not and how is it impacted: soft tissue, partial bony, or full bony.”(California dentist)

“It depends on what kind of third molars. Erupted? Soft tissue, partial or full impaction? It makes a difference on the fee charged. Also, if there is a cyst involved.” (Maryland oral surgeon)

“$239.00 is for erupted 3rds that need surgical extractions and $378.00 for horizontal impactions with unusual complications.” (General dentist)

For more on this survey see: Fees For Wisdom Teeth Removal.

All Impacted Wisdom Teeth Can Be Removed By Dentists, Survey Reveals

All Impacted Wisdom Teeth Can Be Removed By Dentists Survey Reveals18% of dentists feel impacted wisdom teeth do not need to be removed, but if they do, 76% feel GPs are qualified to remove most impacted wisdom teeth.

One dentist stated, “All dentists are qualified to pull teeth.”

The Wealthy Dentist conducted a survey asking dentists if impacted wisdom teeth automatically be removed and if GPs should do the removal.

In this survey, here’s what dentist respondents revealed:

Impacted wisdom teeth should automatically be removed: 25% yes definitely, 57% usually but not always, and 18% no.

GP’s handing the removal: 76% feel they can handle most procedures, while 24% felt dentists are not qualified to remove impacted wisdom teeth.

Many dentists felt GP’s should be able to perform any dental procedure they are trained for and feel comfortable handling.

Here’s what else dentists had to say about removing impacted wisdom teeth —

“It depends upon the individual’s skill and comfort level as to if they should remove impacted teeth or any other surgical procedures for that matter.” (Illinois dentist)

“Each situation needs an individual ‘wait-and-see’ decision, Some look bad early and turn and erupt into place. Others turn for the worst and become impacted and need to be removed. Many are OK over time.” (Massachusetts orthodontist)

“All dentists know or should know their interests and experience. Extracting complicated teeth can be learned through incremental experience and continued education, just like any other complicated dental discipline. Learning does not stop with the presentation of a dental license.” (Canadian dentist)

“I generally only extract impactions as an act of mercy to those who cannot afford an oral surgeon. Anesthesia is the problem, not the removal.” (General dentist)

“Like most procedures, GPs can remove most impactions with proper training.. And like most procedures, experience, experience, experience is necessary to provide the patient with a safe, comfortable, predictable outcome.” (West Virgina dentist)

“Advanced training after dental school is usually needed to do advanced impaction removal with the least amount of trauma to the patient. Usually with IV sedation.” (Alaska dentist)

“Most general dentists do not have additional instruments needed should a complication or unexpected difficulty arises. Also, specifically with impacted teeth, unless the dentist has advanced his/her training beyond dental school and routinely does these procedures an a daily basis, they place their patient at increased risk for both complication and increased morbidity.” (Florida oral surgeon)

“It all depends on the general practitioner’s experience and comfort level of what he feels qualified to do.” (Arizona dentist)

“In our litigious society it is better to refer anything that can be done better by a specialist, including molar endocrinologist. It is not worth the trouble and the patient’s will love you for referring. You lose patients on whom you do extractions – spoken with 50 years experience.” (New York dentist)

“If third molars lack space to erupt into functional and maintainable positions they should be given STRONG consideration for removal! See the AAOMS White Paper regarding Third Molars – it is excellent evidence-based information.” (Pennsylvania oral surgeon)

“It takes extra training to remove most even slightly impacted wisdom teeth. GP’s are certainly qualified to get that extra training in order to remove them without complications.” (Texas dentist)

“In some cases I will consult the treating orthodontist to see if he/she feels there is enough room for the wisdom teeth to erupt without any damaging effect to the completed orthodontic case.” (Illinois dentist)

“Any GP should know his/her clinical boundaries whether it’s removing impacted wisdom teeth, correcting a bite, or any scope of dentistry. OS’s usually do the procedure quicker and at less trauma to the patient. They are more expensive though. If wisdom teeth are buried deep, fully erupted or not symptomatic in any way, they can stay in my honest opinion.” (New York dentist)

“The current practice of waiting for complete development and then surgically removing with a 6% chance of parasthesia and other morbidity is ludicrous. The early minimally invasive of the developing tooth prior to calcification can be done in 2 minutes with almost no risk. Between 8-11 years of age the (mandibular) bud is at the crest of the ridge and is very easily accessed prior to 2nd molar eruption. The tooth bud can be saved for the highest quality stem cells available that have been shown to be multi-potent.” (Illinois dentist)

 (Louisiana dentist)

What are your thoughts on the removal of impacted wisdom teeth?  Are dentists qualified to remove impacted wisdom teeth?

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