Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

No wisdom in routinely pulling wisdom teeth, study says

29.04.2005


No reliable studies exist to support removal of trouble-free impacted wisdom teeth, according to a systematic review of evidence. Despite this surprising lack of data, extraction of third molars has long been considered appropriate care in most developed countries.



“Watchful monitoring” of asymptomatic wisdom teeth may be a more appropriate strategy, suggest review authors led by Dr. Dirk Mettes of Radboud University Medical Centre Nijmegen in the Netherlands. Furthermore, they add, health risks and cost-effectiveness of surgery deserve greater consideration.

“Prudent decision-making, with adherence to specified indicators for removal, may reduce the number of surgical procedures by 60 percent or more,” the authors say.


The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic. mpacted wisdom teeth can cause inflammation of the gum, gum and bone disease, damage to adjacent teeth and development of cysts and tumors. General agreement exists that removal is appropriate when pain or problems occur.

However, the benefits of surgery are much less clear when it comes to removal of disease-free impacted wisdom teeth. Despite of a thorough review of the literature, the reviewers found no data to support this treatment approach.

Mettes and his colleagues could not locate any reliable studies of routine wisdom tooth removal in adults. They found two studies of the practice in adolescents, yet together these included just over 200 participants.

The studies focused only on whether removal of wisdom teeth prevents crowding in the lower jaw within five years, and neither study revealed a significant benefit. “The conclusion drawn from [the larger] study was that the removal of impacted third molars to reduce or prevent late incisor crowding cannot be justified,” say the review authors.

However, crowding is not the problem, according to Dr. Richard Haug, of the American Association of Oral and Maxillofacial Surgeons, and coinvestigator on two current studies on wisdom teeth.

Haug, executive associate dean of the University of Kentucky College of Dentistry, says wisdom teeth that are not pulled can cause decay and inflammation of the gums. "Getting these teeth out earlier makes sense.”

In 24 years of practice, Haug says he has found that the best time to remove impacted wisdom teeth with the lowest rate of complication is between the ages of 17 to 21. “Roots may not be fully formed and are softer, and you have a young, healthy population that heals better than an older population.”

Noting that only two studies were involved in the systematic review, he says, “It was a very elegant review with very high standards; the parameters for inclusion were wonderful but could hardly be replicated by the vast majority of studies that have appeared in the literature.”

Mettes attributes the dearth of studies to two factors: the difficulty and expense of monitoring dental changes over the requisite 10 to 20 years and the lack of adults with impacted wisdom teeth, due to the prevalence of routine removal in recent decades.

“The third molar controversy is still ongoing,” concludes Mettes. “As with all surgical procedures, the surgeon wants to do surgery, it is his or her profession. However, systematic prophylactic removal of impacted third molars is not evidence-based but only practice-based and usual care. From a patient point of view, nonsurgical treatment should be the first option in an asymptomatic environment.”

Mettes TG, et al. Interventions for treating asymptomatic impacted wisdom teeth in adolescents and adults (Review). The Cochrane Database of Systematic Reviews 2005, Issue 2

The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions.

Dirk Mettes | EurekAlert!
Further information:
http://www.cochrane.org
http://www.cfah.org

More articles from Studies and Analyses:

nachricht Do microplastics harbour additional risks by colonization with harmful bacteria?
05.04.2018 | Leibniz-Institut für Ostseeforschung Warnemünde

nachricht Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Writing and deleting magnets with lasers

Study published in the journal ACS Applied Materials & Interfaces is the outcome of an international effort that included teams from Dresden and Berlin in Germany, and the US.

Scientists at the Helmholtz-Zentrum Dresden-Rossendorf (HZDR) together with colleagues from the Helmholtz-Zentrum Berlin (HZB) and the University of Virginia...

Im Focus: Gamma-ray flashes from plasma filaments

Novel highly efficient and brilliant gamma-ray source: Based on model calculations, physicists of the Max PIanck Institute for Nuclear Physics in Heidelberg propose a novel method for an efficient high-brilliance gamma-ray source. A giant collimated gamma-ray pulse is generated from the interaction of a dense ultra-relativistic electron beam with a thin solid conductor. Energetic gamma-rays are copiously produced as the electron beam splits into filaments while propagating across the conductor. The resulting gamma-ray energy and flux enable novel experiments in nuclear and fundamental physics.

The typical wavelength of light interacting with an object of the microcosm scales with the size of this object. For atoms, this ranges from visible light to...

Im Focus: Basel researchers succeed in cultivating cartilage from stem cells

Stable joint cartilage can be produced from adult stem cells originating from bone marrow. This is made possible by inducing specific molecular processes occurring during embryonic cartilage formation, as researchers from the University and University Hospital of Basel report in the scientific journal PNAS.

Certain mesenchymal stem/stromal cells from the bone marrow of adults are considered extremely promising for skeletal tissue regeneration. These adult stem...

Im Focus: Like a wedge in a hinge

Researchers lay groundwork to tailor drugs for new targets in cancer therapy

In the fight against cancer, scientists are developing new drugs to hit tumor cells at so far unused weak points. Such a “sore spot” is the protein complex...

Im Focus: The Future of Ultrafast Solid-State Physics

In an article that appears in the journal “Review of Modern Physics”, researchers at the Laboratory for Attosecond Physics (LAP) assess the current state of the field of ultrafast physics and consider its implications for future technologies.

Physicists can now control light in both time and space with hitherto unimagined precision. This is particularly true for the ability to generate ultrashort...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

Unique scope of UV LED technologies and applications presented in Berlin: ICULTA-2018

12.04.2018 | Event News

IWOLIA: A conference bringing together German Industrie 4.0 and French Industrie du Futur

09.04.2018 | Event News

 
Latest News

Diamond-like carbon is formed differently to what was believed -- machine learning enables development of new model

19.04.2018 | Materials Sciences

Electromagnetic wizardry: Wireless power transfer enhanced by backward signal

19.04.2018 | Physics and Astronomy

Ultrafast electron oscillation and dephasing monitored by attosecond light source

19.04.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>