ROSEMONT, Illinois – It's a scenario that's played out in every part of the country. Your family dentist has recommended you take your teenaged son to an oral and maxillofacial surgeon to have his third molars, or wisdom teeth, removed. Your son is not experiencing any problems with his teeth right now; what should you do? Until recently consensus among dental professionals was hard to find.

According to the results of the Third Molar Clinical Trials, a seven-year study conducted under the auspices of the American Association of Oral and Maxillofacial Surgeons (AAOMS) and the Oral and Maxillofacial Surgery Foundation, wisdom teeth, even those that display no current signs of disease, may increase the risk of chronic oral infectious disease, periodontitis and tooth decay, and should be considered for removal in young adulthood.

The study supports a growing body of evidence suggesting that untreated periodontitis, a bacterial infection of the gums, ligaments and bone that support the teeth and the major cause of tooth loss, provides a portal into the bloodstream for pathogenic bacteria in affected patients.

While oral bacteria associated with periodontal disease have been linked to more serious health problems, including coronary artery disease, stroke, renal vascular disease, diabetes and other complications in older adults, the Third Molar Clinical Trials is the first study to find that young adults also appear to be at risk, particularly from periodontitis affecting third molars. Retained third molars pose other health risks for affected patients, and may even lead to the development of cysts or tumors in the jaws.

Periodontitis in the third molar region is difficult to treat successfully and once established, may be impossible to eliminate. Because third molars are difficult to access, fillings and crowns are often hard to place and maintain. It is often necessary to replace these restorations several times during the patient's lifetime.

Raymond P. White, Jr., DDS, PhD, lead researcher in the Third Molar Clinical Trials, and Dalton L. McMichael Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, NC, suggests that in light of these findings, removing the third molars during young adulthood may be the most prudent option. If a decision is made to retain the third molars, he notes, patients should be aware that their third molars should be evaluated on a regular basis.

SOURCE: American Association of Oral and Maxillofacial Surgeons

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