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Abstract

Prophylactic extraction of unerupted asymptomatic third molars is the most common oral surgery procedure in the United States. However, limited evidence exists to justify its costs and associated morbidity. We analyzed data collected over 25 years from 416 adult men enrolled in the Veterans Affairs Dental Longitudinal Study to evaluate the association of retained asymptomatic third molars with risk of adjacent second molar pathology (caries and/or periodontitis), based on third molar status (i.e., absent, erupted, or unerupted). Unerupted molars were further categorized as either “soft tissue” or “bony” impacted. We found that the lowest prevalence and incidence of second molar pathology occurred when the adjacent third molar was absent. The presence of a third molar that was soft tissue impacted increased the risk of incident second molar pathology 4.88-fold (95% confidence interval: 2.62, 9.08). Having an erupted or “bony” impacted third molar increased the risk of incident second molar pathology by 1.74 (95% confidence interval: 1.34, 2.25) and 2.16 (95% confidence interval: 1.56, 2.99), respectively. The retention of third molars is associated with increased risk of second molar pathology in middle-aged and older adult men.

Keywords

caries periodontal disease cohort study alveolar bone loss longitudinal study

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References

American Association of Oral and Maxillofacial Surgeons (2013). The Management of Impacted Third Molar Teeth. URL accessed on 9/25/2013 at: http://www.aaoms.org/docs/practice_mgmt/condition_statements/impacted_third_molars.pdf.

American Public Health Association (2008). Policy Statement No. 20085: Opposition to Prophylactic Removal of Third Molars (Wisdom Teeth). URL accessed on 9/25/2013 at: http://www.apha.org/advocacy/policy/policysearch/default.htm?id=1371.

Ash

Costich

Hayward

(1962). A study of periodontal hazards of third molars. J Periodontal 33:209-219.

Blakey

Jacks

Offenbacher

Nance

Phillips

Haug

. (2006). Progression of periodontal disease in the second/third molar region in subjects with asymptomatic third molars. J Oral Maxillofac Surg 64:189-193.

Blakey

Hull

Haug

Offenbacher

Phillips

White

Jr (2007). Changes in third molar and nonthird molar periodontal pathology over time. J Oral Maxillofac Surg 65:1577-1583.

Blakey

Golden

White

Jr Offenbacher

Phillips

Haug

(2009). Changes over time in the periodontal status of young adults with no third molar periodontal pathology at enrollment. J Oral Maxillofac Surg 67:2425-2430.

Dodson

(2010). Wisdom tooth extraction: Goals gone wild. Dental Abstracts 55:4-5.

Dodson

Rafetto

Nelson

(2012). Introduction to Proceedings of the Third Molar Multidisciplinary Conference Washington, DC, October 19, 2010. J Oral Maxillofac Surg 70(9):S2-S3.

Elter

Cuomo

Offenbacher

White

Jr (2004). Third molars associated with periodontal pathology in the Third National Health and Nutrition Examination Survey. J Oral Maxillofac Surg 62:440-445.

10.

Elter

Offenbacher

White

Beck

(2005). Third molars associated with periodontal pathology in older Americans. J Oral Maxillofac Surg 63:179-184.

11.

Flick

(1999). The third molar controversy: framing the controversy as a public health policy issue. J Oral Maxillofac Surg 57:438-444.

12.

Friedman

(2007). The prophylactic extraction of third molars: a public health hazard. Am J Public Health 97:1554-1559.

13.

Friedman

Presson

(2010). Wisdom tooth extraction in perspective. Dental Abstracts 55:228-229.

14.

Garaas

Fisher

Wilson

Phillips

Shugars

Blakey

. (2012). Prevalence of third molars with caries experience or periodontal pathology in young adults. J Oral Maxillofac Surg 70:507-513.

15.

Kapur

Glass

Loftus

Alman

Feller

(1972). The Veterans Administration longitudinal study of oral health and disease. Int J Aging Human Develop 3:125-137.

16.

Marciani

(2012). Is there pathology associated with asymptomatic third molars? J Oral Maxillofac Surg 70(suppl 1):15-19.

17.

Mettes

Nienhuijs

van der Sanden

Verdonschot

Plasschaert

(2005). Interventions for treating asymptomatic impacted wisdom teeth in adolescents and adults. Cochrane Database Syst Rev 2:CD003879.

18.

National Institute for Health and Care Excellence (2000). Guidance on the Extraction of Wisdom Teeth: Technology Appraisals Guidance No 1. URL accessed on 9/25/2013 at: http://publications.nice.org.uk/guidance-on-the-extraction-of-wisdom-teeth-ta1

19.

Schei

Waerhaug

Lovdal

Arno

(1959). Alveolar bone loss as related to oral hygiene and age. J Periodontol 30:7-16

20.

Song

Landes

Glenny

Sheldon

(1997). Prophylactic removal of impacted third molars: an assessment of published reviews. Br Dent J 182:339-346.

21.

White

Jr (2007). Progress report on Third Molar Clinical Trials. J Oral Maxillofac Surg 65:377-383.

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Retained Asymptomatic Third Molars and Risk for Second Molar Pathology

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