Third molar surgery (wisdom tooth extraction) in patients 25 years of age and older has a very low incidence of complications and minimal impact on quality of life, according to the results of the American Association of Oral and Maxillofacial Surgeons (AAOMS) Age-Related Third Molar Study, published in the August issue of the Journal of Oral and Maxillofacial Surgery.
The national study of 3,700 patients and 8,300 third molars extracted by 63 oral and maxillofacial surgeons (OMSs) between January and December 2001 shows that "the removal of third molars in an adult patient population is a safe surgical procedure with minimal morbidity, no mortality and no long-term negative impact on the patient's quality of life," according to principal author Richard H. Haug, DDS, professor of oral and maxillofacial surgery and executive associate dean at the University of Kentucky College of Dentistry in Lexington.
"This study offers the largest prospective evaluation to date of patients aged 25 years and older undergoing third molar surgery," says Dr. Haug. "It also provides OMSs with reliable data related to preoperative risk factors and postoperative complications for this specific population. Previous studies have relied on smaller samples, all age ranges or retrospective analysis, limiting the ability for direct comparison."
Almost one third of patients (31.2% to 34.1%) had only minimal inconvenience associated with their surgery and neither missed work nor curtailed their normal activities. Intraoperative complications occurred with a frequency of less than 1%. None of the patients required a blood transfusion, there were no deaths, and none of the patients experienced problems with their airways after surgery, although the frequency of airway compromise during surgery was 0.5%.
With the exception of alveolar osteitis (dry socket), which occurred with a frequency of 2 or 3 per thousand extractions (0.2% and 0.3%) for maxillary (upper jaw) wisdom teeth and slightly more than 1 in 10 (11.9% to 12.7%) for mandibular (lower jaw) wisdom teeth, postoperative complications occurred with very low frequency. Numbness or tingling of the chin, lower lip and jaw, the second most common complication occurred with a frequency of 1.1% to 1.7%.
The study provides a wealth of additional information about third molar patients and surgery, notes Dr. Haug. For example, almost half (43.5% to 53.3%) of extracted teeth will be associated with some form of pathology, most frequently decay (17.6% to 20.3%), gum disease (11.6% to 17.6%) and infection (6.3% to 16.7%).
The most frequent third molar extractions will involve all four third molars (26.5%), followed by a combination of two molars (0.7% to 5.2%), a single tooth (7.2% to 13.2%) and three teeth (2.6% to 2.8%).
The American Association of Oral and Maxillofacial Surgeons (AAOMS), the professional organization representing more than 7,000 oral and maxillofacial surgeons in the United States, supports its members' ability to practice their specialty through education, research, and advocacy.
AAOMS members comply with rigorous continuing education requirements and submit to periodic office examinations, ensuring the public that all office procedures and personnel meet stringent national standards.