An evaluation of referrals requesting third molar tooth removal: clinical diagnosis and treatment outcome.

Introduction To determine the reasons why patients are referred requesting removal of third molar teeth.Method Prospective evaluation of referrals requesting removal of third molar teeth only. Following review of symptoms, clinical, and if appropriate, radiographic findings, a diagnosis according to pre-defined criteria was made, and verified by a senior member of staff.Results 662 individual referrals were received requesting removal of 1,117 individual third molar teeth, of which 73% were for mandibular teeth. A total of 195 teeth (17.6%) were not removed as there was no disease process or insufficient symptoms. In 124 cases (11.1%) a diagnosis of temporomandibular disorders was made with no dental surgery being required. Other reasons for patients not proceeding to surgery were: no symptoms or sign of disease; symptoms were from an adjacent tooth; only single episode of pericoronitis; late incisor crowding; and cervical sensitivity.Conclusion While most patients referred did proceed to have removal of third molar teeth, a significant proportion had symptoms related to chronic orofacial pain that would not have been influenced by removal of third molar teeth. The overall incidence of temporomandibular disorders within the patient sample, either as a primary, secondary or tertiary diagnosis was 18.7%.