Perception of the need for removal of impacted third molars by general dentists and oral and maxillofacial surgeons.

This prospective study investigated the influence of professional training and method of payment on how dental practitioners planned extraction of impacted third molars. The subjects were four groups of dental practitioners in metropolitan Chicago: 1) general dentists in traditional fee-for-service practice; 2) general dentists who were members of a preferred provider organization; 3) general dentists who were members of an Independent Practice Association model of a capitation system; and 4) oral and maxillofacial surgeons, all of whom were in fee-for-service practice. A carefully selected and trained professional actress, in good health, with four unerupted, impacted, and asymptomatic third molars, brought her recently taken full mouth periapical and panoramic radiographs to randomly selected dentists for a consultation. The number of planned extractions (no treatment was ever done) was compared. Data showed that oral and maxillofacial surgeons suggested significantly more extractions than capitation dentists and the average of all general dentists, combined.