Abstract
Aims
To investigate the reasons for extraction of third molars (3Ms) at Tufts University School of Dental Medicine (TUSDM) and compare this to the UK’s NICE guidelines.
Methods
Data were collected at TUSDM retrospectively from 99 patients who underwent surgery in 2019 under American Dental Association (ADA) codes D7220, D7230, D7240 and D7241 (removal of impacted tooth in soft tissue, partially bony, completely bony and with unusual surgical complications). Patient details of age, location of 3M, Winter's classification of impaction, reason for extraction, need for bony removal, type of anaesthesia or sedation, prescribed medications and complications were recorded.
Results
A total of 274 surgical extractions of teeth were recorded. Ages ranged from 15 to 39, with an average age of 24. Intravenous sedation (IVS) was used in 80% of patients with an average of 3.6 3Ms extracted in each of these patients, when local anaesthetic was used alone an average of two 3Ms were extracted. Ninety per cent and 78.7% of maxillary and mandibular 3Ms, respectively, were extracted with no pathology. Thirteen per cent of mandibular 3Ms were extracted due to pericoronitis (usually a single episode), 4% due to caries and 2.3% due to distal second molar (2M) caries. There were five instances of post-operative complications, the worst being hypoesthesia of the right inferior dental (ID) nerve for 3 months.
Conclusion
Wisdom teeth are removed earlier at Tufts for prophylactic reasons with the intention of preventing future problems and caries in the adjacent tooth. More evidence is required to decide which patients would benefit from prophylactic extractions.
To investigate the reasons for extraction of third molars (3Ms) at Tufts University School of Dental Medicine (TUSDM) and compare this to the UK’s NICE guidelines.
Methods
Data were collected at TUSDM retrospectively from 99 patients who underwent surgery in 2019 under American Dental Association (ADA) codes D7220, D7230, D7240 and D7241 (removal of impacted tooth in soft tissue, partially bony, completely bony and with unusual surgical complications). Patient details of age, location of 3M, Winter's classification of impaction, reason for extraction, need for bony removal, type of anaesthesia or sedation, prescribed medications and complications were recorded.
Results
A total of 274 surgical extractions of teeth were recorded. Ages ranged from 15 to 39, with an average age of 24. Intravenous sedation (IVS) was used in 80% of patients with an average of 3.6 3Ms extracted in each of these patients, when local anaesthetic was used alone an average of two 3Ms were extracted. Ninety per cent and 78.7% of maxillary and mandibular 3Ms, respectively, were extracted with no pathology. Thirteen per cent of mandibular 3Ms were extracted due to pericoronitis (usually a single episode), 4% due to caries and 2.3% due to distal second molar (2M) caries. There were five instances of post-operative complications, the worst being hypoesthesia of the right inferior dental (ID) nerve for 3 months.
Conclusion
Wisdom teeth are removed earlier at Tufts for prophylactic reasons with the intention of preventing future problems and caries in the adjacent tooth. More evidence is required to decide which patients would benefit from prophylactic extractions.
| Original language | English |
|---|---|
| Journal | Oral Surgery |
| Early online date | 26 Feb 2021 |
| DOIs | |
| Publication status | E-pub ahead of print - 26 Feb 2021 |
ASJC Scopus subject areas
- Surgery
- Oral Surgery