Naeem Adam, Prof. PJ Sandler

Introduction

Mounting evidence has found the retention of asymptomatic, impacted third molars has potentially placed a generation of patients at risk of distal surface caries (DSC) in the second molar. DSC is frequently identified late, and consequently has a poor prognosis. We provide an overview of the ongoing debate, discuss the potential for DSC, and present a typical situation where asymptomatic third molar retention led to the preventable loss of a second molar.

Aim

To explain and illustrate how the retention of asymptomatic, impacted third molars, as a result of following NICE guidance, has potentially left a generation of patients at risk of future disease and tooth loss.

Methods and Results

A critical review of the most pertinent literature and guidance to date followed by a case report illustrating the possible consequences of apparently ill-conceived NICE guidance.

Conclusion

NICE guidance on the extraction of wisdom teeth has had little, long-term, impact on the number of patients requiring third molar removal. In favouring the retention of asymptomatic, partially erupted, mesioangular impacted third molars this guidance has placed a generation of patients at risk of DSC in the second molar. DSC is frequently identified late, it often has a poor prognosis, and overall caries risk does not appear to accurately capture the risk of DSC.

Information

All content is accurate at time of writing but may become inaccurate over time. Any content images are the copyright of The JTG, or their respective rights holders if otherwise mentioned, and cannot be used without prior permission. Please contact us for content queries. 

 

Contact Us

  +44(0) 207 405 8074
  This email address is being protected from spambots. You need JavaScript enabled to view it.
  Junior Trainees Group
     British Association of Oral & Maxillofacial Surgeons
     Royal College of Surgeons of England
     35/43 Lincoln's Inn Fields, London, WC2A 3PE