Caution for those going into OMFS for Private Practice/Teeth

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jqrsDental

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PSA to everyone going into OMFS for private practice/dental procedures. The days of a secure future in private practice are numbered. One company is planning to ablate wisdom teeth buds before they become wisdom teeth which will undercut oral and maxillofacial surgeons like never before. It is marketed to general dentists and pediatric dentists in mind and has already completed animal testing. If you do not love big OR procedures and want to spend most of your career doing dentoalveolar, all I can say is good luck.

triagenics.com

Home - TriAgenics, Inc

Revolutionary Zero3 TBA (3rd molar tooth bud ablation) one-minute procedure prevents wisdom teeth from ever forming. Safe. Effective. Simple
triagenics.com triagenics.com

Secondly, it is increasingly a subject of debate for oral surgeons to perform anesthesia while doing procedures. I would not expect this to be here for more than 10 years. Again, if performing office-based anesthesia is one of the reasons you will apply and go through a grueling residency, think hard.

To lose all wisdom teeth extractions and then to lose anesthesia is a great blow. I feel sympathy for those going into oral and maxillofacial surgery especially those with many years left between dental school and residency and beyond. Consider doing another dental specialty if you are hoping for a majority of your time being spent in private practice such as periodontics. A 4-6 year grueling residency only to have the private practice landscape completely altered is a risk I would not recommend to anyone. I'm quite thankful I am going for periodontics because I love it. This only confirms the decision was correct.
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This would be quite the detriment to OMS. However, I don’t think this automatically means someone should do perio lol. Also, OMS has a really strong record of anesthesia so I’m not convinced they’ll lose it.
 
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I'll let the residents and attendings comment on the future of the specialty. All I want to say is: what a cool new technology!
 
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A prospective perio resident (dental student maybe?) lecturing practicing surgeons on the death of their specialty, gotta love it.

There are many threats to the future of private practice OMFS, which have and continue to be exhaustively discussed on these threads. I would be surprised if this piece of tech is one of them. Their website is pretty light on the science and heavy on the $$$ and marketing. Not to mention 95% of animal trials fail in humans. Maybe they should consider marketing to the veterinarians.
 
jqrsDental said:
I would not recommend to anyone.
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As mentioned above, you do not hold the credentials to be making such statements. It makes me wonder if you're a dental student trying to thin out your OMFS competition...

This website has inaccuracies and the treatment has not even entered phase I clinical trials as it's pending FDA approval. If it were to reach the market, it would not likely be covered by insurance. So no one is losing "all wisdom teeth extractions".

It's an interesting topic to discuss, but why don't you ask a question about it instead of making inaccurate statements that will mislead people.
 
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Jaa_ said:
You need to work on your situational awareness. As mentioned above, you do not hold the credentials to be making such statements. It makes me wonder if you're a dental student trying to thin out your OMFS competition...

This website has inaccuracies and the treatment has not even entered phase I clinical trials as it's pending FDA approval. If it were to reach the market, it would not likely be covered by insurance. So no one is losing "all wisdom teeth extractions".

It's an interesting topic to discuss, but why don't you ask a question about it instead of making inaccurate statements that will mislead people.
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Why would it not be covered with insurance if they make it the standard of care as they claim? Could this not also change the reimbursements of wisdom teeth? Not trying to be inflammatory just want to make sure everyone is aware since lots of people at my school want to do OMFS for private practice. The residents too.
 
Lol the OP is the perfect example of a JD - a jealous dentist.

I’ve come across countless individuals just like yourself. I wouldn’t be surprised if this individual wanted to get into omfs, but couldn’t because he was not competitive enough to even apply. They end up hating on omfs, thinking that it will make themselves feel better. Often they settle for perio bc it’s significantly easier to get into (as long as you have a pulse and the money to pay for it).

Listen closely : our anesthesia team model has proven to be both safe and effective for a century. There is nothing controversial about it. We will continue to administer it, in ”10 years” and beyond.
 
Silver_arrow said:
Lol the OP is the perfect example of a JD - a jealous dentist.

I’ve come across countless individuals just like yourself. I wouldn’t be surprised if this individual wanted to get into omfs, but couldn’t because he was not competitive enough to even apply. They end up hating on omfs, thinking that it will make themselves feel better. Often they settle for perio bc it’s significantly easier to get into (as long as you have a pulse and the money to pay for it).

Listen closely : our anesthesia team model has proven to be both safe and effective for a century. There is nothing controversial about it. We will continue to administer it, in ”10 years” and beyond.
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Ad hominem aside, what is the response for the triagenics ablating a big part of dentoalveolar? We will always still have soft tissue procedures anyways.
 
jqrsDental said:
Ad hominem aside, what is the response for the triagenics ablating a big part of dentoalveolar? We will always still have soft tissue procedures anyways.
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My response to this?

Remember when implants were going to kill endodontists?

Remember when Invisalign was going to kill orthodontists?

Remember when the caries vaccine or… community fluoridation was going to kill general dentistry?

Seems like there’s always a dentistry killer right around the corner. This hasn’t even touched humans yet, and if this does even progress, it’ll be years before it even gets into phase 4 clinical trials. My guess is at least 5 years for phases I to III then another 3-5 for IV due to the nature of the treatment. That’s not accounting for the administrative time in between as well.

Also, according to the website, the treatment is for 6-12 year olds. According to US census, kids under 12 make up 15% of the population. So on the off chance that this becomes a real thing after 15 years, what happens to the other 85% of the US population (290 million people) that does have wisdom teeth? And do you think every single kid 6-12 is going to get this treatment? Even cheap successful and non invasive dental treatments haven’t killed off dentistry, what makes you think this will kill off OS?

On a side note, why are so many perios talking smack against OS? In dental school, only the perios would tell me how much time I would waste, how general dentists doing implants would kill the profession blah blah blah.
 
LegendaryPanda said:
My response to this?

Remember when implants were going to kill endodontists?

Remember when Invisalign was going to kill orthodontists?

Remember when the caries vaccine or… community fluoridation was going to kill general dentistry?

Seems like there’s always a dentistry killer right around the corner. This hasn’t even touched humans yet, and if this does even progress, it’ll be years before it even gets into phase 4 clinical trials. My guess is at least 5 years for phases I to III then another 3-5 for IV due to the nature of the treatment. That’s not accounting for the administrative time in between as well.

Also, according to the website, the treatment is for 6-12 year olds. According to US census, kids under 12 make up 15% of the population. So on the off chance that this becomes a real thing after 15 years, what happens to the other 85% of the US population (290 million people) that does have wisdom teeth? And do you think every single kid 6-12 is going to get this treatment? Even cheap successful and non invasive dental treatments haven’t killed off dentistry, what makes you think this will kill off OS?

On a side note, why are so many perios talking smack against OS? In dental school, only the perios would tell me how much time I would waste, how general dentists doing implants would kill the profession blah blah blah.
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Always reminds of every "death of radiology due to AI" thread I come across on med forums.

Also how are general dentists who already often refuse to do simple extractions going to be removing tooth buds?
 
Silver_arrow said:
They end up hating on omfs, thinking that it will make themselves feel better. Often they settle for perio bc it’s significantly easier to get into (as long as you have a pulse and the money to pay for it).
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Not to add fuel to fire, but just so you know, matching into Perio is statistically more difficult than Ortho, OMS, Peds, etc when you look at percent of applicants accepted. ADEA has released statistics for the last year and Perio had either the lowest or second lowest (with Prosth) match rates when you look at the percent of applicants who match. It is several percentage points lower than the rates of OMS applicants who match, LOL.

This is coming from someone who will never apply to Perio & has no stake in the convo. Just thought you’d know your statements aren’t coming off as any less “JD.” Maybe fact check before coming for an entire profession based off one post, lol.

 
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dentalinthemental said:
Not to add fuel to fire, but just so you know, matching into Perio is statistically more difficult than Ortho, OMS, Peds, etc when you look at percent of applicants accepted. ADEA has released statistics for the last year and Perio had either the lowest or second lowest (with Prosth) match rates when you look at the percent of applicants who match. It is several percentage points lower than the rates of OMS applicants who match, LOL.

This is coming from someone who will never apply to Perio & has no stake in the convo. Just thought you’d know your statements aren’t coming off as any less “JD.” Maybe fact check before coming for an entire profession based off one post, lol.

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My cousin just applied to PA school and told me the average acceptance rate is 20%. So you’re telling me that applying to PA is significantly harder than every single dental specialty including general?
 
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LegendaryPanda said:
My cousin just applied to PA school and told me the average acceptance rate is 20%. So you’re telling me that applying to PA is significantly harder than every single dental specialty including general?
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I’m not saying the barriers to entry are more difficult, but yes, if that number is accurate, I would say being accepted into PA school statistically is more difficult as an applicant, yes. PA schools usually require over 1000 hours (at minimum) of direct patient contact, which is no joke. That’s kind of the math/reality of it, regardless of our own emotional response.
 
dentalinthemental said:
I’m not saying the barriers to entry are more difficult, but yes, if that number is accurate, I would say being accepted into PA school statistically is more difficult as an applicant, yes. PA schools usually require over 1000 hours (at minimum) of direct patient contact, which is no joke. That’s kind of the math/reality of it, regardless of our own emotional response.
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I don’t even know what to say. So you’re telling me that spending 1000 hours doing something and being somewhere is harder than studying to score 75 percentile on the DAT then getting good grades enough to specialize?

Also, you forgot that the statistics are from those who have interviewed. We have no way of knowing how many applicants there were period. It’s possible that perio likes to send out interviews for everyone or OS likes to hold off on interviews. Who knows.

Lastly, regarding your post, so it’s easier except for barrier of entry. Are you trolling or what? Barrier of entry should be pretty much the most important factor. Otherwise it was harder to get into my crappy restaurant job than it was into dental school, which is a point you failed to understand.
 
I applied for a job at McDonalds last year. 1 position, 4 people. “25% acceptance rate.” Neurosurgery has a 74.3% match rate. That means McDonalds is statistically more difficult to get into. Significantly. It’s just facts people. Stats are never misleading.
 
carabelliscusp said:
Always reminds of every "death of radiology due to AI" thread I come across on med forums.

Also how are general dentists who already often refuse to do simple extractions going to be removing tooth buds?
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If you actually click the link, it is marketed to be very easy to do by making a 3d printed guide then the machine aims at the tooth buds removing them without any trauma. Every parent is going to want this, and even their negative marketing alone against OMFS should decrease their bottomline.

Also please don't derail the thread with the tired perio vs other specialty thing. Competition aside, at least perio's bread and butter isn't being threatened by wisdom teeth ablation done by general dentists and pediatric dentists or anesthesia being affected by joint statements by many dental and anesthesia providers.

www.asahq.org

Joint Statement on Pediatric Dental Sedation

www.asahq.org www.asahq.org
"Joint Statement from the American Society of Anesthesiologists, the Society for Pediatric Anesthesia, the American Society of Dentist Anesthesiologists, and the Society for Pediatric Sedation Regarding the Use of Deep Sedation/General Anesthesia for Pediatric Dental Procedures Using the Single-Provider/Operator Model"
 
LegendaryPanda said:
My response to this?

Remember when implants were going to kill endodontists?

Remember when Invisalign was going to kill orthodontists?

Remember when the caries vaccine or… community fluoridation was going to kill general dentistry?

Seems like there’s always a dentistry killer right around the corner. This hasn’t even touched humans yet, and if this does even progress, it’ll be years before it even gets into phase 4 clinical trials. My guess is at least 5 years for phases I to III then another 3-5 for IV due to the nature of the treatment. That’s not accounting for the administrative time in between as well.

Also, according to the website, the treatment is for 6-12 year olds. According to US census, kids under 12 make up 15% of the population. So on the off chance that this becomes a real thing after 15 years, what happens to the other 85% of the US population (290 million people) that does have wisdom teeth? And do you think every single kid 6-12 is going to get this treatment? Even cheap successful and non invasive dental treatments haven’t killed off dentistry, what makes you think this will kill off OS?

On a side note, why are so many perios talking smack against OS? In dental school, only the perios would tell me how much time I would waste, how general dentists doing implants would kill the profession blah blah blah.
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You really think that invisalign did not affect orthodontists at all?

Also 85% of the population also includes those that either had wisdom teeth removed, not indicated for removal, or do not want them removed. The crux of the issue is that these 6-12 year olds are the next batch of wisdom teeth patients for the oral surgeons. If even 50% of their wisdom teeth are ablated, you now have half the "demand" for the equal "supply" of oral surgeons.

Lastly, this is not talking smack rest assured. For oral surgeons that do big trauma cases and other operating room procedures, more power to them. This is for those that want to repeat the success of past oral surgeons who made a great living on anesthesia and 3rd molars. Scope aside, if you want to be well compensated and be confident in the career landscape, consider periodontics, endo, or other dental specialties/being a general dentist. They don't cost a grueling residency and even better do not have as many threats on the horizon.
 
Once all the wisdom teeth dry up I’m just going to transition to doing all of perio’s procedures. I predict the perio speciality will end up dying out once all the actual surgeons turn their attention to gum gardening. I’d be very concerned about the future of perio if this ends up being viable.
 
DMD12345 said:
I applied for a job at McDonalds last year. 1 position, 4 people. “25% acceptance rate.” Neurosurgery has a 74.3% match rate. That means McDonalds is statistically more difficult to get into. Significantly. It’s just facts people. Stats are never misleading.
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It’s tough when your ego can’t possibly handle the idea that other specialties are statistically more difficult to get into. I never said barrier of entry was tougher— the CBSE is tougher most definitely than the GRE by a landslide and I never said otherwise!
It’s even tougher when you can’t argue facts so you have to resort to made up scenarios and somehow create parallels between Periodontics (an intensive surgical residency that is literally 1 year shorter than many OMS residencies) and McDonalds.
 
dentalinthemental said:
It’s tough when your ego can’t possibly handle the idea that other specialties are statistically more difficult to get into. I never said barrier of entry was tougher— the CBSE is tougher most definitely than the GRE by a landslide and I never said otherwise!
It’s even tougher when you can’t argue facts so you have to resort to made up scenarios and somehow create parallels between Periodontics (an intensive surgical residency that is literally 1 year shorter than many OMS residencies) and McDonalds.
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Lol
 
MarcusA121 said:
Once all the wisdom teeth dry up I’m just going to transition to doing all of perio’s procedures. I predict the perio speciality will end up dying out once all the actual surgeons turn their attention to gum gardening. I’d be very concerned about the future of perio if this ends up being viable.
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That makes one of us… I think I’d rather file for bankruptcy than do another SRP to be honest
 
dentalinthemental said:
I’m not the original poster, I don’t think OS is going anywhere and it’s a very important profession. It’s more telling on your end if you have to diminish the importance of other specialties and careers instead of just seeing statistics for what they are and not getting butthurt over it.
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Chill. I’m just illustrating your logic isn’t correct. You’re the one drawing a conclusion for a statistic instead of seeing it for what it is: one number. I see you’ve ignored other peoples’ comments…
 
dentalinthemental said:
It’s even tougher when you can’t argue facts so you have to resort to made up scenarios and somehow create parallels between Periodontics (an intensive surgical residency that is literally 1 year shorter than many OMS residencies) and McDonalds.
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Gum grafts and implants = intensive surgery
 
Silver_arrow said:
Often they settle for perio bc it’s significantly easier to get into (as long as you have a pulse and the money to pay for it).
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MarcusA121 said:
I predict the perio speciality will end up dying out once all the actual surgeons turn their attention to gum gardening.
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IMG_9826.gif


Big Hoss
 
Interesting technology. I wonder if zapping the area with heat waves can damage the IAN or pulp damage to the 2nd molar. Kinda hard to test in a pig.

“Good news Mom, we stopped little Jimmy’s wisdoms teeth from coming in. Bad news, he’ll never feel his chin and is gonna need 4 root canals”
 
LegendaryPanda said:
@ OP

Some patients don’t even want to come in for a cleaning for their kid every six months. You must be high out of your mind if you think every parent is gonna want this.

@ the other guy

Got any perio interviews yet?
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Would this not cause the population to push for cuts in reimbursements

Wisetoothshucker said:
Interesting technology. I wonder if zapping the area with heat waves can damage the IAN or pulp damage to the 2nd molar. Kinda hard to test in a pig.

“Good news Mom, we stopped little Jimmy’s wisdoms teeth from coming in. Bad news, he’ll never feel his chin and is gonna need 4 root canals”
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They market it as gentle heating of the buds. Hard to say if it will be easier to market as x rays but must be scary for some aspiring to be oral surgeons when their whole field can change in the next 10 years. That gives them what- a few years at most to have the traditional practice?

axiumgod said:
Gum grafts and implants = intensive surgery
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This was never supposed to be an interspecialty battle ground. Im not ashamed to be a future gum gardener if the procedures I do have the same reimbursement but lower barrier to entry than oral surgery. Please if we can keep on the subject of tooth bud ablating technology and anesthesia privileges being a possible threat to oral surgeons that future applicants should consider, that would be a more interesting conversation.
 
Don’t forget the amount of general dentists, pediatric dentists, and even possibly periodontists jumping on this technology and pushing for this to be the new standard of care
 
jqrsDental said:
Don’t forget the amount of general dentists, pediatric dentists, and even possibly periodontists jumping on this technology and pushing for this to be the new standard of care
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Keep typing away on your burner account that you created 2 days ago 🥱

If this technology were to become a thing, why would you think a general dentist would send a referral to a periodontist over an oral surgeon for tooth bud ablation? If there is damage to the IAN caused by this technology (you can’t say this couldn’t happen), OMFS can handle these complications. You’re grasping at straws.
 
jqrsDental said:
Would this not cause the population to push for cuts in reimbursements


They market it as gentle heating of the buds. Hard to say if it will be easier to market as x rays but must be scary for some aspiring to be oral surgeons when their whole field can change in the next 10 years. That gives them what- a few years at most to have the traditional practice?


This was never supposed to be an interspecialty battle ground. Im not ashamed to be a future gum gardener if the procedures I do have the same reimbursement but lower barrier to entry than oral surgery. Please if we can keep on the subject of tooth bud ablating technology and anesthesia privileges being a possible threat to oral surgeons that future applicants should consider, that would be a more interesting conversation.
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Lower barrier of entry huh? Why would you want a specialty with a "lower barrier of entry?"
 
jqrsDental said:
Would this not cause the population to push for cuts in reimbursements


They market it as gentle heating of the buds. Hard to say if it will be easier to market as x rays but must be scary for some aspiring to be oral surgeons when their whole field can change in the next 10 years. That gives them what- a few years at most to have the traditional practice?


This was never supposed to be an interspecialty battle ground. Im not ashamed to be a future gum gardener if the procedures I do have the same reimbursement but lower barrier to entry than oral surgery. Please if we can keep on the subject of tooth bud ablating technology and anesthesia privileges being a possible threat to oral surgeons that future applicants should consider, that would be a more interesting conversation.
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I'm gonna try to be nicer than the rest of the people in this thread and try to put it to you another way.

Do you think Vascular Surgeons have gone out of business after statins, GLP-1 agonists, DOACs, metformin etc have come on the market? Do you think Interventional cardiologists are hurting thanks to the same market forces?

Do you think neurologists are hurting for business because of the ubiquitous availability of low out-of-pocket cost ACEi, ARBs, calcium channel blockers, beta blockers etc?

How about dermatologists, in an era of increased awareness/use of sunscreen?

Gyn-oncs are out of business because of the HPV vaccine?

If people refuse to use such cheap, relatively safe, and long-established methods to reduce their risk of developing any number of conditions that require these specialists to treat them (or develop them in spite of using these preventative methods), what makes you think a substantial segment of the population is going to adopt/be able to afford this method of preventative treatment for their childrens' thirds.

If your prediction that this technology is going to completely eliminate third molars from the population, how many years do you think that will realistically take? My guess is at least 30-40. So essentially the majority of a career in OMFS if you stay healthy, save well, don't get divorced.

Also, while I agree that maybe OMFS won't have the market cornered on the performing of these ablations, do you really think they, at some point, won't see the writing on the wall in this dooms day scenario and be well-equipped to start doing it themselves? Do you think that with the current anesthesia model (the specailty will never stop fighting to protect it), there is anyone who would provide this service in a more safe, expeditious, and cost effective method anyway? Unless you think a bunch of pre-teens are gonna tolerate this ablation procedure under local and a bunch of pediatric dentists are gonna be comfortable lasering back there/willing to eat the cost of/pass the cost of a DA on to the patient, don't you think OMFS would have some role here as well?

If you end up being right, which is possible, it is my hope that I will have had 25 years in successful, rewarding practice by the time your prediction comes true, and will have adapted my practice to survive this and keep busy until my body/mind quit on me.

Best of luck with the application for resdiency!
 
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How many years have we heard about scientists discovering a molecule that eliminates cavities or regrows teeth? If we buy into all of this none of us will have a job. Stop being salty you didn’t get into OMFS.

scitechdaily.com

90% Reduction: Scientists Discover Natural Molecule That Eradicates Plaques and Cavities

3,3′-Diindolylmethane (DIM) decreased the Streptococcus mutans biofilm, a leading contributor to plaque and cavities, by 90%. A significant portion of the global population experiences persistent issues with dental plaque and cavities or will face them at some time. While toothpaste, mouthwash, a
scitechdaily.com

Sincerely,
A GP
 
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HockeyDocOMFS said:
Keep typing away on your burner account that you created 2 days ago 🥱

If this technology were to become a thing, why would you think a general dentist would send a referral to a periodontist over an oral surgeon for tooth bud ablation? If there is damage to the IAN caused by this technology (you can’t say this couldn’t happen), OMFS can handle these complications. You’re grasping at straws.
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The reason is this guys marketing it to nonoral surgeons so even if omfs do them too the sheer amount of nonoral surgeons makes it a relevant factor.

Burner account in case any controversy although we are all polite.
 
White_Sponge_Nevus said:
I'm gonna try to be nicer than the rest of the people in this thread and try to put it to you another way.

Do you think Vascular Surgeons have gone out of business after statins, GLP-1 agonists, DOACs, metformin etc have come on the market? Do you think Interventional cardiologists are hurting thanks to the same market forces?

Do you think neurologists are hurting for business because of the ubiquitous availability of low out-of-pocket cost ACEi, ARBs, calcium channel blockers, beta blockers etc?

How about dermatologists, in an era of increased awareness/use of sunscreen?

Gyn-oncs are out of business because of the HPV vaccine?

If people refuse to use such cheap, relatively safe, and long-established methods to reduce their risk of developing any number of conditions that require these specialists to treat them (or develop them in spite of using these preventative methods), what makes you think a substantial segment of the population is going to adopt/be able to afford this method of preventative treatment for their childrens' thirds.

If your prediction that this technology is going to completely eliminate third molars from the population, how many years do you think that will realistically take? My guess is at least 30-40. So essentially the majority of a career in OMFS if you stay healthy, save well, don't get divorced.

Also, while I agree that maybe OMFS won't have the market cornered on the performing of these ablations, do you really think they, at some point, won't see the writing on the wall in this dooms day scenario and be well-equipped to start doing it themselves? Do you think that with the current anesthesia model (the specailty will never stop fighting to protect it), there is anyone who would provide this service in a more safe, expeditious, and cost effective method anyway? Unless you think a bunch of pre-teens are gonna tolerate this ablation procedure under local and a bunch of pediatric dentists are gonna be comfortable lasering back there/willing to eat the cost of/pass the cost of a DA on to the patient, don't you think OMFS would have some role here as well?

If you end up being right, which is possible, it is my hope that I will have had 25 years in successful, rewarding practice by the time your prediction comes true, and will have adapted my practice to survive this and keep busy until my body/mind quit on me.

Best of luck with the application for resdiency!
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Well said thank you. With the negative obvious ad hominem and attacks on oral surgeons as being greedy by the creator of this triagenics technology would you be concerned the public starts to speak out about wisdom teeth costs?

Again for all those upset this is really just a topic of discussion that I would want others to know about if applying or considering surgery. A classmate told me about it and it seems important for the dental student population to know.
 
jqrsDental said:
Well said thank you. With the negative obvious ad hominem and attacks on oral surgeons as being greedy by the creator of this triagenics technology would you be concerned the public starts to speak out about wisdom teeth costs?

Again for all those upset this is really just a topic of discussion that I would want others to know about if applying or considering surgery. A classmate told me about it and it seems important for the dental student population to know.
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I think next time, if you really just want to create a topic of discussion, ask about our thoughts on ablation of tooth buds/how it will affect the profession and post the article.

No need for the “ORAL SURGERY IS DEAD. PERIO IS BETTER THAN ORAL SURGERY” angle. That’s where you created your problem. This could’ve been a nice discussion, but you set it up like a troll would from the beginning.
 
Pablo Sanchez said:
I think next time, if you really just want to create a topic of discussion, ask about our thoughts on ablation of tooth buds/how it will affect the profession and post the article.

No need for the “ORAL SURGERY IS DEAD. PERIO IS BETTER THAN ORAL SURGERY” angle. That’s where you created your problem. This could’ve been a nice discussion, but you set it up like a troll would from the beginning.
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Touche. Still a very revolutionary technology. Wonder if it will be like invisalign in the orthodontist world .
 
I am very skeptical of this technology. So many unknowns at this stage. One thing I noticed no one has talked about is the lingual nerve and possible parasthesias/dysesthesias/hypoesthesias that could occur as a result of ablating third molar buds.
It is well known that the lingual nerve is present at or above the alveolar crest in 13% of individuals. Hence the need for a hockey stick angled incision when attempting to lay a full thickness flap to remove an impacted mandibular third molar. Studies would need to be done to understand the position of the lingual nerve in relation to the tooth bud in pediatric patients. Neither a CBCT nor even a medical grade CT can reveal the position of the lingual nerve. Hence, their so called method of using CBCTs or 3D radiographs to create surgical guides for this procedure would do nothing to help avoid injury to the lingual nerve. I noticed that the study that this company published makes mention of how the IAN function was preserved but made no mention of whether or not the lingual nerve was impacted. This is pretty important, as lingual nerve injuries are much more devastating than IAN injuries.

This is just one of many issues I see with this technology. I'm sure there are so many other issues I haven't even thought of. With new technologies, there are always unseen or unpredicted adverse side effects. Just take a look at the complications now arising with COVID vaccines based on mRNA technology (not that I'm saying that we should not get vaccinated against COVID). I think this is an extreme measure to be taking in pediatric patients. Why would we go about trying to cause trouble irradiating children when we don't even know yet if their third molars will erupt into occlusion normally or be impacted. It simply is irrational and unwarranted to irradiate everyone. You will end up doing more harm than good.

In short, I see no reason why we should be using this to ablate tooth buds. It seems ridiculous to me. It was originally developed as a relatively noninvasive way to ablate tumors (both malignant and benign), particularly for people who have contraindications to surgical resection. I think that's exactly what it should be used for-tumors, not teeth.
 
To further add to my argument, take a look at the article posted here:

This is a study discussing the anatomical variation and studying the relation of developing third molar buds in relation to the IAN canal and the lingual nerve. Here is a snippet depicting clearly a perforation/discontinuity at the lingual cortex of a young child's mandible. If you were to irradiate the tooth bud here in this radiograph with microwave radiation, there would be no lingual cortical bone at that perforation to prevent the heat from spreading into the lingual tissue, which could very well house the lingual nerve.
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Another key issue is the fact that children will likely need to be very still for this procedure, lest you run the risk of them thrashing and having the radiation not be delivered in a precise targeted zone. This would likely necessitate the use of general anesthetics, including sevoflurane, propofol, ketamine, etc. All of these are proven to cause neuroapoptosis in developing children. So you're telling me you want to expose these young children to general anesthesia and all of the associated risks all because they MIGHT have an impacted wisdom tooth in the future? That's ridiculous.

I am confident that once the FDA receives their application for review on use of this technology in humans (particularly CHILDREN subjects), it will be denied due to the risks outweighing the benefits. I would never let my kid be a test subject in this study-the entire premise is ludicrous. The standards, safety precautions, and ethical considerations for delivering care to pediatric patients is much higher and more stringent than with adults, and rightfully so. I am just an OMFS resident and I've already thought of all these issues. I'm sure the FDA has many intelligent people who will find many more issues with this company's technology and proposition.
 
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