Monitoring the Periodontal Status of Wisdom Teeth

An interesting article titled “Monitoring for Periodontal Inflammatory Disease in the Third Molar Region,” appears in the April 2015, issue of the Journal of Oral and Maxilofacial Surgery written by Brent A. Golden and et. al. (vol. 73, issue 4). The study looked at participants who had asymptomatic wisdom teeth and sought to assess the periodontal status of those wisdom teeth at 2 year intervals for 6 years.

The participants in the study were taken to have healthy periodontal status of their wisdom teeth if the probing depths were less than 4 mm. A total of 129 such patients were included in the study. In actuality the study participants were a subsample of another larger study were patients had 4 asymptomatic wisdom teeth. The subsample included all participants with a healthy periodontal status (all probing depths less than 4 mm) in the wisdom teeth region, defined as distal of second molars and around adjacent third molars, with clinical data collected at three 2-year intervals. Eighty-nine percent of those in the study visited a dentist at least occasionally, all of them brushed their teeth at least daily, and 67% used dental floss.

After 6 years of the study, one-fourth of the participants had decided to have their wisdom teeth removed. The most often reported reason for extraction was wisdom caries (33%) with pain and periodontal reasons reported almost equally (27% and 23%, respectively). Prevention (17%) was the least reported reason for wisdom teeth removal.

After 2 years of the study 6% of participants had wisdom teeth and 58% continued with no clinical evidence of periodontal pathology in the wisdom teeth region (all probing depths less than 4 mm). After 4 years of the study 24% of participants had wisdom teeth removed and 49% continued with all probing depths less than 4 mm in the wisdom teeth region. After 6 years, 47% of participants had wisdom teeth removed and 32% continued with all probing depths less than 4 mm in the wisdom teeth region.

The results from the study suggest that around 1/3 of all healthy disease free asymptomatic wisdom teeth remain free of periodontal pathology after six years. Even so the authors encourage physicians to not generalize the results to all patients as most in the study were Caucasian and young adults.

The authors state

“Absent any other data, it might be reasonable to estimate that one third of young adults could retain third molars with no periodontal pathology over time and the one fourth with neither caries nor periodontal pathology could do so. Conversely, three fourths of young adults would be expected to have either or both of these conditions.”

The authors feel that an additional well designed study is needed and feel their data from this study can be useful in designing that study and getting others on-board for a new study.

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