Dentistry and Oral Health

Biography

Biography: Jinesh Shailesh Thakrar

Abstract

Third molar surgery is one of the most common procedures performed in oral surgery. There is no controversy when it comes to removing third molars which show signs of pathology or present with symptoms but prophylactic removal of third molars has caused lots of debates for a number of years. Before the National Institute for Clinical Excellence (NICE) created the guidelines for third molar extractions, wisdom teeth extraction was a very common procedure costing the NHS around £30 million per year and roughly £20 million was spent privately. From 27^th March 2000 NICE published guidelines on wisdom teeth removal resulting in a decrease in 30% of wisdom teeth extractions. It does not however include distal decay in the second molar as a reason for removal. My research project looked at wisdom teeth referrals into Birmingham Dental Hospital, UK and assessed which NICE guidance category they fell under as well as if there was any radiographic evidence of distal decay in the second molar. A total of 69 cases were assessed, 45 female and 22 male. The most common age group of referrals was between 24 and 30 with 61% of all cases presenting with a vertical impaction. Caries was the most common reason for referral (39%) with 22% of all cases having radiographic evidence of caries in the lower second molars. Of those that presented with caries in the lower second molars only 33% had it mentioned in their referral letter and this was most commonly in mesially impacted lower wisdom teeth. There is relatively low proportion of those with evidence of caries in the second molar and so I would not consider it to be a necessary change for NICE guidelines. I would however put more emphasis providing oral hygiene advice to patients with mesially impacted wisdom teeth.