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The Wisdom Teeth Debate
Have you ever wondered how a dentist or medical doctor comes up with a diagnosis for his or her patients? In today’s world of MRI’s, lasers and high technology, it may surprise you to learn that the basics of how to determine what is wrong with a person dates back thousands of years ago, with the Greeks.
One of the most prominent and influential of the ancient physicians was Hippocrates. His systematic approach to the diagnosis and treatment of patients nearly 25 centuries ago helped to set the foundation for how dentists and medical doctors approach their patients today.
So, how does a dentist or medical doctor determine whether a condition is abnormal, and therefore requires treatment?
This is where the ancient Greeks have contributed to our understanding of diagnosis and treatment of disease. To determine if a condition requires treatment, the dentist or medical doctor must first ask himself or herself the following questions: “Does disease presently exist?” and “Will disease ultimately occur if no treatment is given?” If the answer is “yes” to either of these questions, the condition will require treatment. It is important to note that in most cases, a dentist or medical doctor must also know the natural history of the disease to answer these questions.
A good example is found when considering the need to surgically remove wisdom teeth. This subject has caused some debate in the dental community in recent years. Some general dentists and oral surgeons believe that all wisdom teeth that are impacted (covered with gum and or bone) should be removed if there is not enough room in the mouth for them.
Treatment at a young age (17-21) is considered less risky because younger people usually heal more quickly, and are less likely to have other health problems that can complicate the surgery and recovery. Other dentists believe that impacted wisdom teeth should be removed only when there is infection, pain, a tumor or cyst, or the wisdom tooth is damaging or about to damage adjacent teeth or other parts of the mouth.
This is where we can apply the insight of the ancient Greeks. In situations where impacted wisdom teeth are not causing problems or any potential problems, I often suggest periodic observation. Because the removal of wisdom teeth does have a degree of risk from the anesthesia as well as the procedure, I believe that a conservative approach that carefully weighs the risks versus the benefits is prudent.
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