Indications for third molar surgery.

Recent reports have suggested that the practice of prophylactic lower third molar surgery is widespread, possibly account for up to 50% of all patients treated. An objective effort to refute the findings of the previously published data was undertaken by the Maxillofacial Unit of a large district general hospital trust. A prospective study of 454 consecutive patients referred for third molar surgery demonstrated that in 96% of the patients, at least one nationally defined criteria for surgery was present. A concurrent retrospective audit of patients already on the waiting list for surgery identified that 97% had at least one valid criterion for surgery. Of those patients who presented with unilateral symptoms, over half had only the troublesome side removed. Only 11 out of 454 patients were accepted for treatment without a defined criterion, all of whom had partially erupted teeth. The evidence presented in the current study is compared with previously reported data and possible reasons for the variance are discussed.