Tag Archives | third molar

Wisdom Teeth Facts – From Symptoms & Occurrence to Extractions & Precautions

What are Third Molars? A permanent dentition typically consists of 32 teeth and third molars or wisdom teeth are the most posterior teeth present on each quadrant. They are located the farthest in a dental arch and are usually the last ones to erupt. The third molars are formed due to evolutionary factors but with modern lifestyle and eating habits, they are no longer necessary. This is why smaller jaws have inadequate space to accommodate the eruption of third molars and all they do is cause pain, infection and discomfort. When Do Wisdom Teeth Erupt & Why? Wisdom teeth usually erupt between the ages of 16 to 25 but they may also erupt at a later stage for some. According to popular belief, wisdom teeth were used by ancestors for grinding plant tissues. Since our ancestors had a huge mouth which accommodated more teeth for digesting cellulose, third molars became a part of the tooth development process. This is why most of the time wisdom teeth either remain submerged under the gum or erupt only partially. Indications of Extraction If the jaw is large enough to accommodate the eruption of third molars and if they are aligned correctly, an extraction […]

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Effect of Eruption Status of the Mandibular Wisdom Teeth on Distal Caries in the Adjacent Second Molar

An article titled “Effect of Eruption Status of the Mandibular Third Molar on Distal Caries in the Adjacent Second Molar,” written by Feiwu Kang and et. al. appears in  the 2016 issue of J Oral Maxillofac Surg. The article explores the eruption of mandibular wisdom teeth and their effect on adjacent second molars. A total of 500 cone beam computed tomography (CBCT) images of mandibular third molar (MTMs) from 469 patients were evaluated. The authors assessed the presence of distal caries in mandibular second molars (MSMs), impaction depths and angulations of MTMs, cementoenamel junction (CEJ) distances between distal MSMs and mesial MTMs, presence of pericoronitis in MTMs, and patient characteristics (age and gender). The authors state that previous studies show the prevalence of distal caries in MSMs has ranged from 13.4 to 30.1%. The authors found that the overall prevalence of distal caries in the mandibular second molars was 52.0%. According to the classification of Pell and Gregory, position A was the impaction depth at which most distal caries in MSMs were present (P= .036). For angulation of the mandibular third molars, when mesial angulations were 43 to 73%, MSMs developed more distal caries (P < .0001). Previous studies have reported that […]

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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 […]

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Improving Value: Prespectives from Oral Surgeons

An interesting editorial appears in the 2014, issue of the Journal of Oral and Maxillofacial Surgery titled “The Value of Improving Value,” by James Hupp (pp. 843-845, issue 72). In this Dr. Hupp presents a formula for patient value Value = A(Q + PS)/C A = appropriateness, Q = quality, PS = patient satisfaction, and C = costs The author states “First, one can improve outcomes while keeping costs the same. Second, one can decrease costs while keeping outcomes the same. Or third, both outcomes and costs increase, but outcomes per unit of cost improve.” In the article the author discusses how in the past, value in health care was really just about cost cutting. Clinical outcomes were not really taken into account. Now that health care outcomes are being considered, physicians need to find ways to measure value using the new equation. Dr. Hupp describes an antidotal example of a group of Swedish orthopedic surgeons who discuss hip replacement strategies at a meeting and share their outcomes data. From this they saw some surgeons had better outcomes and attempted to learn why those surgeons had better outcomes. Dr. Hupp points out that sharing outcome data and then using this to […]

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Differing Views in Medicine and Dentistry Applied to Wisdom Teeth

An interesting article appears in the 2014 version of the Journal of Oral and Maxillofacial Surgery titled “Asymptomatic Third Molars Under Nominalist and Essentialist Lenses,” written by V. Wallace McCarlie and Daniel L. Orr II, pp. 658-659.  The authors define two differente views: 1) essentialism and 2) nominalism and then try to apply them to the management of wisdom teeth. The authors state “Essentialism is the notion that underlying every properly defined disease is an unchanging reality causing illness. Conversely, nominalism is not concerned with underlying causes, but rather with signs and symptoms of illness.” In the article the authors mention a study which says that dentists detect rather than diagnose. The authors later say that detection implies nominalism and diagnosis implies essentialism. The authors give some downsides to both points of view. For example, they say essentialism is less focused on the patient and treatment. They say nominalism does not focus on causes which may be important for prevention. The authors state “An example of the importance of not focusing solely on symptoms (nominalism) is the case of asymptomatic impacted third molars. Life-threatening head and neck pathology, such as space infections, necrotizing fasciitis, osteomyelitis, and cysts or tumors, may […]

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