Prophylactic Third Molar Removal: Are Oral Surgeons and Orthodontists Aligned in Preventive Approaches?

Abstract

Background: A consensus favors extracting impacted third molars in the presence of clinical symptoms, but no consensus exists on their management when asymptomatic. Healthcare professionals from different fields of expertise may approach the extraction of these teeth differently. Methods: This study aimed to compare the perspectives of oral surgeons and orthodontists regarding the indications for asymptomatic third molar removal. This cross-sectional study collected information by asking participants why they prefer extracting asymptomatic third molars. Descriptive statistics were used to evaluate the obtained data. The significance level was p<0.05. Results: Prophylactic extraction of partially impacted molars was more favored among the participants (p<0.01). The orthodontists preferred prophylactic extraction due to the risk of late anterior dental crowding (LADC); however, the surgeons preferred pre-pregnancy extractions (p<0.05). The extraction decision for partial impaction was higher in females when the risk of distal caries was considered. For fully impacted ones, it was higher in males when the risk of caries and pericoronitis were considered (p<0.05). Conclusions: Orthodontists preferred extraction because of the risk of LADC and caries, while surgeons focused on preventing pericoronitis, pathology, focal infection, and symptoms during pregnancy. This divergence between the participants may inform the guidelines for prophylactic management of third molars. These findings may be pertinent in gender medicine. Clinical relevance: This study has been enlightening for departments to consult each other before the extraction of a patient's asymptomatic third molar.