SASMFOS POSITION STATEMENT ON THIRD MOLAR (WISDOM TEETH) SURGERY
The South African Society of Maxillofacial and Oral Surgeons (SASMFOS) supports the position taken by the American Association of Oral and Maxillofacial Surgeons (AAOMS) in a recent policy statement that “firmly supports the surgical management of erupted and impacted third molar teeth (wisdom teeth), even if the teeth are asymptomatic, if there is presence or reasonable potential that pathology may occur, caused by or related to the third molar teeth (wisdom teeth)”.
Nationally and internationally, there is an understanding among dental and medical professionals that the removal of third molar teeth (wisdom teeth) is always appropriate when there is evidence of pathological changes such as nonrestorable carious lesions, periodontal disease, infections, cysts, tumours and damage to adjacent teeth. It is important to state that there is also generalised agreement that wisdom teeth that are completely erupted and functional, painless, free of caries, in a hygienic position with a healthy periodontium, without other associated pathologic conditions, are regarded as disease-free teeth that may not require extraction, but do require meticulous hygiene maintenance and regular clinical and radiographic surveillance by a registered dental professional (dentist/dental specialists) if retained.
The necessity for the removal of wisdom teeth has recently been challenged by some political action groups internationally and in South Africa, especially by third-party funders/medical aids/advisors. In response, the South African Society of Maxillofacial and Oral Surgeons, who is an advocate for the practice of evidence-based dentistry and medicine, strongly recommends that treating surgeons and dentists should apply the findings and recommendations of pertinent available scientific data to each of their patient’s cases, they should critically assess treatment options and make decisions through a process of informed consent or refusal, with an appropriate course of action that best fits the needs of the patient.
SASMFOS strongly advises patients and healthcare professionals to consult evidence- based scientific data on the matter, of which examples include:
- American Association of Oral and Maxillofacial Surgeons’ (AAOMS) White Paper on Third Molar Data. (Databases included Ovid Medline, Pubmed, Google Scholar and the Cochrane Database.) www.aaoms.org/docs/third_molar_white_paper.pdf
- Extractions of Impacted Mandibular Third Molars: Postoperative Complications and Their Risk Factors. F. Blondeau & N.G. Daniel. Journal of the Canadian Dental Association 2007:73, no 4: www.cda-adc.ca/jcda/vol-73/issue-4/325.html.
- The effects of NICE guidelines on the management of third molar teeth. L. W. McArdle & T. Renton. British Dental Journal 213, E8 (2012) Published online: 7 September 2012 |oi:10.1038/sj.bdj.2012.780