An interesting article titled “A Retrospective Analysis of Postoperative Abscess Formation Following Wisdom Tooth Removal and Their Clinical Condition and Localization,” written by Jakob Fehlhofer and et. al. appears in the Journal of Contemporay Dental Practice (vol. 23, n. 11, pp. 1079-1084, 2022). The article conducts a study on deep tissue abscesses after wisdom teeth removal to determine potential associated factors.
Specifically the authors conduct a study with 88 patients who had wisdom teeth removed that resulted in a postoperative abscess formation who were treated at the Department of Oral and Maxillofacial Surgery at the FAU in Germany from October 2012 to February 2017. There were 44 male and 38 female patients, who were split into two groups Group A (removal of asymptomatic wisdom teeth) that had 14 male and 19 female patients and Group B (removal of symptomatic wisdom teeth) that had 30 male and 19 female patients.
The authors found that postoperative abscesses more commonly occured in patients in Group B (64.2%) than in Group A (35.8%), but that the results were not statisically significant. Postoperative abscesses occurred more frequently in group B with them mostly commonly in the lower second molar region (IIB).The authors found that the average number of days from removal of wisdom teeth to abscess formation was 15.07 days for group A and 20.3 days for group B. Patients in group B were older and had more surgical abscess incisions needed than those in group A. Patients in group B also ook antibiotics orally for 2 days longer than patients in group A. Further there was no significant correlation found between perioperative antibiotic treatmentm the localization of the abscess, or the number of days from to abscess formation after surgery.
Photo by Ozkan Guner on Unsplash
The authors said detection of potential wisdom tooth pathologies at an early and asymptomatic stage is important in order to not have postoperative complications following wisdom tooth removal. The findings suggest that older patients and patients with symptomatic wisdom teeth are at higher risk of developing abscesses after wisdom teeth surgery.
In discussing the results the authors spend some time discussing the age at which a patient should have a prophylatic wisdom teeth removal. They say that prior studies have shown that complications increase after 40 years of age. They state that in there study older age was correlated with more surgical interventions for abscess
treatment but the younger patients in their study had the most pain. The mention a 2014 where it was shown that optimal time for removal wisdom teeth for preventive reasons was between 17 and 25 years of age. The authors go on to state:
“….prophylactically extracted teeth with a lower development stage also lead to more serious complications. Thus, ‘prophylactic’ removal should be performed only at advanced root development and up to an age of approximately 25 years.”
The authors thus feel that detecting any wisdom teeth pathologies at an early and asymptomatic stage is neccessary to best avoid postoperative complications from surgery.