The American Association of Oral and Maxilofacial Surgeons (AAOMS) has some additional information they appear to have added more recently to their third molar research news section. For those considering how to best manage their wisdom teeth they should take a look at
http://www.aaoms.org/docs/govt_affairs/advocacy_white_papers/management_third_molar_white_paper.pdf
and
http://www.aaoms.org/images/uploads/pdfs/management_third_molar_supporting_information.pdf.
The first document describes what many different oral surgeons groups including AAOMS currently suggest for managing wisdom teeth. The article says
“There are a variety of recognized management choices for third molars, including removal, partial removal (coronectomy), retention with active clinical and radiographic surveillance, surgical exposure, tooth repositioning, transplantation, surgical periodontics, and marsupialization of associated soft tissue pathology with observation and possible secondary treatment.”
The article says that a decision to remove or retain healthy asymptomatic wisdom teeth should be made before a patient is 30. The position statement is said
“Predicated on the best evidence-based data, third molar teeth that are associated with disease, or are at high risk of developing disease, should be surgically managed. In the absence of disease or significant risk of disease, active clinical and radiographic surveillance is indicated.”
When wisdom teeth have no disease and no symptoms the surgeon should review the likelihood of pathology developing in the future, functionality, risks of removal, risks of retention, and protocol for active surveillance.
The second document describes what can happen when wisdom teeth are retained. Possible problems can develop including 1) Dental caries, 2) Pericoronitis, 3) Root resorption, 4) Periodontitis, 5) Infections (local and fascial space), 6) Cysts, 7) Tumors, and 8) Mandible fractures. I have discussed these problems in more detail on http://www.teethremoval.com/risks_of_keeping_wisdom_teeth.html.
The article points out several key points. An absence of symptoms associated with wisdom teeth does not equate to the absence of disease. Pocketing around wisdom teeth is an important indicator of periodontal disease, especially when bleeding occurs on probing. The majority of patients with retained, asymptomatic disease-free wisdom teeth eventually require surgical management. The article provides several recommendations such as to limit the known risks and complications associated with surgery, it is medically appropriate and surgically prudent to remove wisdom teeth in patients with pathology before they are 30 and before complete root development.