Dentists' Reasons for Third Molar Removal in NW PRECEDENT

Objectives: Removal of third molars is one of the most common dental surgical procedures in the United States, representing 95% of all extractions among 16-21 year-olds. However, the prophylactic removal of asymptomatic third molars has been the subject of considerable controversy. Some advocate early removal of third molars to prevent future pathology and minimize operative and post-operative risks. Others recommend against the removal of asymptomatic third molars, due to increased morbidity and cost. This study investigates dentists' recommendations to remove or retain third molars in 16 – 22 year-olds. Methods: An ongoing practice-based study is assessing third molar management in Northwest PRECEDENT, 5-state dental research network. This report describes the results from the first phase of the study. Subjects were recruited if they had at least one third molar present, and had not undergone prior third molar removal. The dentists' recommendations on removal or retention were based on clinical and radiologic exams, after which the dentists' written recommendations, along with reasons, were collected. Results: 729 subjects were recruited, with a mean age of 18.5 years. 49% were female. For 59% of the subjects, one or more third molars were recommended for removal. The most common reasons for third molar removal were unfavorable orientation/unlikely to erupt (43%), prevention of future problems (29%), or because other third molars needed extraction (10%). Retention of third molars was recommended in 41% of the enrollees, with the primary reasons being too early to decide (64%), third molars already fully erupted (14%), or third molars had favorable eruption paths (12%). Conclusions: Northwest Precedent dentists recommended removal of third molars for the majority of their 16 to 22 year-old patients, and their primary reasons were unfavorable orientation and prevention of future problems. Supported by NIDCR grants DE016750 and DE016752.