Review Article| Volume 20, ISSUE 2, P253-261, September 2012

Controversy, Evidence, and Third Molar Management

      Given the prevalence of third molars, high incidence of associated pathology, and cost of care (surgical or active surveillance), decision-making and management strategies for third molars have received a great deal of attention. Understandably, there are controversies that surround wisdom teeth, including the optimal time for treatment, if and when to prescribe medications such as antibiotics, steroids, and analgesics, the actual costs (financial and otherwise) of treatment and retention, and what constitutes monitoring of retained teeth. The “gorilla in the room,” however, involves what are appropriate indications for the removal of third molars, particularly those that are asymptomatic. The debate has intensified as proponents of retaining asymptomatic third molars have focused their concerns on cost containment (Fig. 1).
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      Fig. 1A 16-year-old girl with 4 unerupted and asymptomatic third molars. Clinical examination is necessary to help ascertain physiologic space for eruption and maintenance of these teeth, including quantity and quality of available space. Informed discussion should include possible consequences of surgical management as well as retention, and the impact of age on risks of treatment.
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      Further readings

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