New publication shows uncertainty over the best way to treat wisdom tooth infection

Breaking news: A survey of 289 UK surgeons, led by Mr Geoff Chiu and conducted by Saving Faces and British Association of Oral and Maxillofacial Surgeons (BAOMS)  through their partnership in the National Facial Oral and Oculoplastic Centre (NFORC), illustrates the uncertainty over the best way to treat wisdom tooth infection and recommends further research. The results are now published in the British Journal of Oral and Maxillofacial Surgery.

When there is no room in the jaw for a wisdom tooth to grow normally, it usually emerges at an angle or gets stuck.  These impacted wisdom teeth often become infected, damage adjacent teeth or cause other dental problems. As many of you probably know, these wisdom tooth problems are often very painful for the patient. Sometimes X-rays and scans show that the root of the infected tooth is very close to a nerve and needs to be treated with extra care, as there is a risk of permanent lip numbness if the nerve is damaged during the procedure. These are high-risk cases.

At least two vastly different methods can be recommended for the same patient depending on the surgeon they see.

The surgeon could take out the entire tooth including its roots. This is known as complete surgical removal. An alternative operation called coronectomy is available for the 1 in 5 patients who are at risk of nerve damage. This involves removing the visible part of the tooth while leaving the roots in the gum.

The publication concludes that coronectomy may prevent permanent nerve damage in high-risk cases, however there is a gap in evidence and knowledge to support coronectomy. This shows uncertainty over the best way to treat high-risk cases. As a result, further studies are needed to determine the effectiveness and safety of coronectomy.

Fortunately, NFORC is on the case. In partnership with Mr Geoff Chiu, Consultant Oral and Maxillofacial Surgeon and Professor Paul Coulthard, Dean for Dentistry and Director at the Barts and The London School of Medicine & Dentistry, we will be carrying out further research on 4,000 patients to find out which procedure (complete surgical removal or coronectomy) benefits patients more and which have more complications.

We would like to thank Ahmed Omran, who first proposed the research, Geoff Chiu, Amrita Bose, Roberta Maroni (our very helpful statistician), Jagtar Dhanda, Douglas Hammond, Clare Moynihan, Antonio Ciniglio and the reviewers who have dedicated their time and efforts for the successful publication of this paper.

The current perspectives of the surgical management of mandibular third molars: the need for further research” is now published in the British Journal of Oral and Maxillofacial Surgery, which you can read here.

Masters student awarded distinction for work on facial injuries data collected by Saving Faces

Saving Faces and the British Association of Oral and Maxillofacial Surgeons (BAOMS), in conjunction with The Royal College of Emergency Medicine, undertook two national surveys on the incidence of facial injuries. The data collected represented the only large multi-centre prospective data-set on UK facial injuries presented to secondary care with over 14,700 data collected.

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BAOMS Chair Patrick Magennis comments on the SEND publication in The OTJ Journal November 2019 issue

“This open access paper funded by charity Saving Faces and Cancer Research UK (CRUK) is ground-breaking. OMFS cancer surgeons from all over the UK were involved in the study, and British Association of Oral and Maxillofacial Surgeons (BAOMS) is proud that this research was completed and published.

The study was possible because of a unique collaboration between 68 UK-based surgeons treating 614 patients at 27 UK hospitals. The research compared leaving or taking out neck glands that did not have obvious secondary cancers at the same time as removing the patient’s small mouth cancer. OMFS know that between 20 and 30 in every 100 patients with small mouth cancers have tiny microscopic cancer deposits in their neck glands that can’t be picked up by any scanners. Now OMFS have the evidence about the risks and benefits of removing the neck glands in early mouth cancer. This information will help patients participate in decisions about their treatment.

To mis-quote John F Kennedy in this the 50th anniversary year of the moon landings, OMFS surgeons want to do randomised surgical trials ‘not because they are easy, but because they are hard; because that goal will serve to organise and measure the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone’.

This paper is a credit to all involved.”

– Patrick Magennis, British Association of Oral and Maxillofacial Surgeons (BAOMS) Chair and Saving Faces Deputy Chair of Trustees

Click here to read more about the SEND paper.

Click here to read the full November 2019 issue of The Operating Theatre Journal.

Operating-Theatre-Journal-November-2019

Saving Faces SEND Study Publication Interview with Prof Iain Hutchison – BBC Radio 4 Today Programme, 24 October 2019

Listen to Prof Iain Hutchison on BBC Radio 4 The Today Programme with Sarah Smith discussing the ground breaking results of the SEND study, funded by Cancer Research UK, Elliott Bernerd and Saving Faces.

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Ground breaking UK research by Saving Faces on early mouth cancer could save 21,000 lives world wide every year

Surgery

Headline News 17/10/2019: Findings of ground-breaking new surgical trial on mouth cancer published by the British Journal of Cancer

Access the recommendation on F1000Prime

The findings of the Selective Elective Neck Dissection (SEND study) funded by Elliott Bernerd, Cancer Research UK and Saving Faces, has been published for the first time in the British Journal of Cancer and has been recommended in the F1000 Prime as being of special significance in its field.

  • Patients with mouth cancer benefit from additional surgery
  • 21,000 more patients worldwide could be cured as a result of this finding Continue reading

Rita Neto talks about her internship research experience at Saving Faces

My internship

by Rita Pereira Neto

I had my first contact with Saving Faces at the iMed Conference, a medical conference organised exclusively by medical students at Nova Medical School, where I am also a student. As part of this conference, a Research Challenge was organised and one of the prizes was a 2-week internship with Saving Faces. I was so excited when it was announced I would be going to London to work with Saving Faces.

It needs to be said that this internship surpassed every expectation, which were already quite high. Not only did I learn a lot, I also grew as a person. I feel I am a more equipped medical student.

On the first week, I had the opportunity to go to the Royal London Hospital. At the Trauma Clinic, I was fortunate to see how Maxillo-Facial Surgeons treat their patients. It was very interesting to see patients who just had their accidents the day before and comparing them with patients who were almost fully healed. I had also the opportunity to go to theatre, where I watched cutting-edge surgeries which I would not necessarily have seen during my Medical degree back at my University. The time spent at the hospital allowed me to prepare for my Maxillo-Facial rotation next semester.

For the remaining time, I stayed at the Saving Faces’ offices. Even though some might consider research a “boring subject”, it never ceases to amaze me how research actually can change the way medicine is practiced.

I did some literature reviews for the on-going projects at Saving Faces. That made me feel more confident about writing medical papers on my future work at University. It was surprising to realise that something as simple as a literature review has a right way and a wrong way to be done. There are also some tricks that can be used, and I am thankful that Saving Faces helped me discover some of them.

Furthermore, I was given the opportunity to perform other different tasks (which I was more than happy to do them as I felt that for those two-weeks I was part of the Saving Faces’ workforce) namely, writing some texts to be uploaded to the Saving Faces’ website and developing a campaign poster regarding a Saving Faces’ helpline. Those tasks took me out of my comfort zone and made me develop new skills.

However, the moments where I learned the most, without a doubt, were the round table discussions. In there, everything was discussed from the daily workings of a charity to the writing of papers and funding proposals, passing through some history lessons. The fully consequences of these brainstorming discussions will never be forgotten and for now, I will just say that I am a much open-minded student with a much broader knowledge regarding Clinical Research.

I must thank everyone that so patiently answered all my never-ending questions regarding clinical trials. One thing that immediately comes to my mind when I look back at this internship is how everyone was ready to help in any way they could.

I would like to especially acknowledge Professor Iain Hutchison for giving me this opportunity, for mentoring me, being a role model and for always encouraging me to ask questions.

To Fran Ridout and Sharon Cheung for teaching me all the ins and outs of clinical research and paper publication.

To Tuyet Le and Hannah John for organising my internship so well and to my colleagues Ping San and Imon Pal that guided me throughout my time at Saving Faces.

This internship will have a tremendous positive impact on the way I will practice medicine. I know I will be a better doctor because of it. Thank you all.

Rita Pereira Neto, Medical Student

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