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Clinical Guidelines for the Management of Wisdom Teeth |
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Aetiology:
As the last tooth to erupt, the third molar is most likely to be prevented from coming through in a crowded dentition. Possible reasons for this include a lack of abrasive material in foods and inherited tooth-jaw size incompatibility.
Symptoms:
Pain, swelling, and a foul taste are common symptoms of pericoronitis. Mostly due to localised infection where the third molar has partially erupted into the mouth. Teeth covered in bone are unlikely to become infected. Infections in older, less vascular bone may be harder to treat.
The following NHS guidelines outline the indications for the removal:
1. Recurrent episodes of pericoronitis
2. Unrestorable carious tooth
3. Single episode of pericoronitis which showed evidence of spread of infection into facial tissues, includes abscess and osteomyelitis
4. Contributing to periodontal disease/caries in the adjacent tooth
5. External or internal resorption of 3rd molar or adjacent tooth
6. Disease of the follicle including cysts and tumours
7. To facilitate the restoration of the adjacent tooth or for prosthesis provision
8. Special circumstances: Jaw fractures, orthognathic surgery, radiotherapy, chemotherapy and tumour surgery
Warn the patient of pain, trismus, swelling, and the possibility of damage to the ID and lingual nerves. |
