Removal of third molars-should we have guidelines for surgery?

ABSTRACT

Third molar surgery is the most frequent procedure carried out by the departments of oral and maxillofacial surgery all over the world. The procedure is accompanied by significant risks, with possible damage to the inferior alveolar and/or lingual nerve being of special concern. Considering these risks of morbidity, it is essential to establish the need of removal. National Institute of Clinical Excellence [NICE] in the United Kingdom introduced guidelines for removal of third molars in 2000, advocating that only pathological third molars should be removed. The following article makes reference to a study carried out in England where third molars are extracted in accordance with NICE guidelines. This study was carried out to assess the compliance of general dental practitioners to the NICE guidelines. It was noted that 95% of the patients referred for third molars extraction fulfilled the criteria set forth by NICE. 11% [15] patients who fulfilled the NICE guidelines criteria refused to undergo removal of third molars. Only 5% [7] patients did not meet referral criteria set by NICE guidelines. These guidelines cut down lot of unnecessary referrals and allowed for organization of the patient load by the secondary referral center, as well as limiting unnecessary surgeries and postoperative complications. There is a dire need to define similar guidelines in Pakistan pertaining to the local needs