of Unerupted and Impacted Third Molar Teeth
Key messages for patients
Note: These key messages are
not intended for direct dissemination to patients, but may be incorporated
into local patient information materials.
The pros and cons of removing
unerupted and impacted third molar teeth:
- As a general principle, teeth
should not be removed without due cause. This applies to third molars as
much as it does to any other teeth.
- All forms of surgery carry some
risk of complications. Extraction of unerupted and impacted third molar
teeth sometimes leads to problems such as pain and swelling, together with
the possibility of altered sensation in the lips or tongue. Even in the
best of hands, accidents can occur.
- Where there is adequate space,
unerupted teeth should be left in place to erupt. In childhood, even impacted
teeth may change their position. It is not possible to predict accurately
whether teeth will erupt and there is little evidence that the teeth become
more difficult to remove with age, or that more complications occur by leaving
them in place.
- However, there are some definite
indications for removal of third molars. For example, where there has been
recurrent pain and discomfort due to multiple episodes of infection, then
removal of third molars may be appropriate to reduce the pain and inconvenience
to the patient, time off work, and the risks and costs associated with repeated
- Other situations where it may
be in the patient's best interests to have early removal of third molars
include those whose jobs mean that they may have to work in situations isolated
from expert treatment, or when medical conditions may lead to difficulty
or risk with their removal.
How will the decision be made?
- Your dentist or doctor will
carry out a full assessment, including taking your medical and dental history,
and a clinical examination to see if removal of the tooth or teeth is indicated
and is advisable. He or she will discuss with you the advantages and disadvantages
of removal in your particular case, as well as the possible risks of the
operation. You will also have one or more x-rays of your teeth taken before
any decision to operate is agreed. The clinician should also explain the
implications of a decision not to remove the tooth and any possible problems
in the future.
The operation itself:
- General anaesthesia may be needed
for complex and lengthy operations, but local anaesthesia carries less risk
- Bruising and swelling often
occur following third molar surgery, but usually go within two weeks
- Other common complications of
third molar surgery include bleeding, minor infection, and damage to the
adjacent teeth. Your doctor or dentist will inform you if any problems arise
during surgery and discuss with you if any further treatment is needed.
After the operation:
- Your doctor or dentist will
advise you how to look after your mouth after the operation, e.g. with hot
salty mouthwashes; and what painkillers to take, e.g. paracetamol or ibuprofen.
- There is no evidence to suggest
that antibiotics should routinely be prescribed following third molar removal,
but they may be needed in some cases.
- Before leaving, you should know
how to contact the surgeon in case of emergency. A review appointment may
be arranged, but this is not always necessarily. A letter will also be sent
to your own dentist to let him or her know about the operation and any follow