Risks and benefits of removal of impacted third molars

Mercier, Paul; Precious, David S.

doi:10.1016/s0901-5027(05)80447-3

Cited by 207 publications

(165 citation statements)

References 84 publications

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“…' There is a lack of reliable evidence for the predictability that an unerupted and pathology-free third molar will cause disease. 8,9 A clinician's decision, therefore, has to be based on clinical and radiographic factors and also on the clinician's own perception and experience. Absolute indications and contra-indications for the removal of asymptomatic third molars cannot be established because there are no long-term studies on this subject at the present.…”

Section: Introductionmentioning

confidence: 99%

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Incidence of symptoms in previously symptom-free impacted lower third molars assessed in general dental practice

et al. 2009

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million per annum 1 and around £22 million to the private sector. 2 The enormous number of teeth removed in the UK prompted researchers to assess the type of practice conducted here and in 1998 a study had estimated that around 20-30% of third molars that were removed in the UK did not fulfi l the American National Institutes of Health criteria for removal and were, therefore, removed prophylactically. 3 This was followed by the publication of guidelines by the NICE 4 and SIGN 5 on the management of impacted lower third molars and, possibly as a result, the number of impacted wisdom teeth removed in the UK started to fall. In addition, it is believed that changes in the legislation on the prescription of general anaesthesia have also resulted

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Section: Introductionmentioning

confidence: 99%

“…Absolute indications and contra-indications for the removal of asymptomatic third molars cannot be established because there are no long-term studies on this subject at the present. 8 Data that could help the clinician to decide what is the best treatment for a specifi c patient or case would be of great value.…”

Section: Introductionmentioning

confidence: 99%

Incidence of symptoms in previously symptom-free impacted lower third molars assessed in general dental practice

et al. 2009

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“…5,6 While a great body of evidence exists about the possible signs and symptoms following third molar surgery in terms of pain, swelling, trismus and parasthesia, surprisingly little is known about the consequences of these on a patient's life, and how it affects their day to day life or life quality. [7][8][9][10] Assessment of the physical, social and psychological consequences of health states has been carried out for several decades now in medicine but only recently has it been employed in the dental arena. 11 A plethora of oral health specific quality of life measures (questionnaires) have been developed and their psychometric properties evaluated.…”

Section: Introductionmentioning

confidence: 99%

Changes in life quality following third molar surgery – the immediate postoperative period

et al. 2003

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Objectives This study describes patients' perceptions of changes in oral health related quality of life (OHQOL) in the early postoperative period following third molar surgery. Methods One hundred patients were enrolled in a prospective cohort study of the surgical removal of lower third molars under local anaesthetic. Two specific oral health related quality of life measures, OHIP-14 and OHQoLUK© were administered to the study group prior to surgery. Standardized surgical and analgesic protocols were followed. Patients kept a diary of changes in life quality each postoperative day (POD) for 7 days, completing both OHIP-14 and OHQoLUK© daily. Results Both oral health related quality of life measures identified a significant deterioration in quality of life on POD1 (P<0.01) and this remained evident on POD2 (P<0.01), POD3 (P<0.01), POD4 (P<0.01) and POD5 (P<0.05). By POD6 and POD7 there was no significant difference in quality of life compared with preoperative status (P>0.05). Deterioration in life quality over the study period was associated with postoperative clinical findings (P<0.05): swelling and trismus. Conclusion The study concludes that there is a significant deterioration in oral health related quality of life in the immediate postoperative period following third molar surgery; particularly during the first five days. This is associated with postoperative clinical findings. This has implication for patients deciding on third molar surgery and informed consent.

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“…[12][13][14][15][16][17][18][19][20] A new sample of 55 patients in Sweden and 100 patients in Wales was asked to imagine experiencing the outcomes described in each vignette. Then, the patients were asked to select the health state within each of the five domains that matched how they imagined experiencing the outcomes described in each vignette.…”

Section: Stage 3 Rating Of Outcomesmentioning

confidence: 99%

Third molar treatment outcome: a comparison of patients' preferences in Sweden and Wales

Liedholm

Knutsson

Lysell³

et al. 2005

Br Dent J

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A Ai im m To elucidate and compare patients' outcome preferences for removal and retention of mandibular third molars in Sweden and Wales. S Su ub bj je ec ct ts s a an nd d m me et th ho od d The subjects comprised patients referred and scheduled for removal of one or both mandibular third molars in Sweden and Wales. The multi-attribute utility (MAU) methodology was applied to study patients' preferences for outcomes of removal and retention of the mandibular third molar. R Re es su ul lt ts s Relative weighting of domains was similar in the two countries. 'Home and social life' received the highest relative weighting in Sweden and 'general health and wellbeing' in Wales. 'Your appearance' received the lowest relative weighting in both countries. In both Sweden and Wales operative jaw fracture was considered to be the outcome with most impact and dentigerous cyst and imbricated incisors the least impact. Outcome ranking was similar in both countries and operative outcomes were considered by patients to be more detrimental to health than retention outcomes. C Co on nc cl lu us si io on ns s This comparison showed that patients' preferences in Sweden and Wales were similar and that the outcomes of surgery were considered worse after third molar removal than retention. Patientorientated treatment decisions were less subject to variation than clinician-orientated decisions. INTRODUCTIONEvidence-based healthcare incorporates the 'conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients' . 1 This approach to healthcare encourages clinicians to interpret evidence on an individual patient basis and to include assessment of patient outcome preference in decision making. Patients' preferences in healthcare settings reflect many factors. It is increasingly appar- ent that these are both medical and non-medical, and include social, cultural and economic factors. Whilst traditional utility assessment methods fail to integrate non-medical factors, 2 multi-attribute utility (MAU) methodology, allows assessment of both medical and non-medical factors. 3

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Risks and benefits of removal of impacted third molars

Cited by 207 publications

References 84 publications

Incidence of symptoms in previously symptom-free impacted lower third molars assessed in general dental practice

Incidence of symptoms in previously symptom-free impacted lower third molars assessed in general dental practice

Changes in life quality following third molar surgery – the immediate postoperative period

Third molar treatment outcome: a comparison of patients' preferences in Sweden and Wales

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