Gerald S. Fine, D.D.S.
Oral and Maxillofacial Surgery
Make the connection!
What your patient never asks YOU!!! A few weeks ago a 24-year-old patient was referred to our office for the removal of his third molar teeth. He had recently moved to Boston from Atlanta, Georgia and told me he had regular dental visit with his family dentist. It had never before been suggested that he have his third molar teeth be removed so what had changed? My patient was skeptical of his "new" dentist's dental recommendation; but did not feel that he could ask him. The development of periodontal disease in the young adult begins in the area of the mandibular third molars then spreads to the other teeth. The most accurate indicator of periodontal health or disease seems to be periodontal probing depth. Measuring the periodontal probing depth in six sites per tooth can allow an estimate of how severe the periodontal disease is. Reducing the periodontal probing depth to 4mm or less will reduce inflammatory responses and improve the overall periodontal health.
These factors were explored in relationship to the removal of the third molar teeth. A recent study measured the periodontal status via probing of 69 patients. With-in this group were patient who had all four third molar teeth removed as well as patients who had only one maxillary or one mandibular third molar tooth removed. Periodontal depth measurements at six sites were obtained both before as well as 2½years after the third molar teeth were removed.
Considering the periodontal depth as a marker of periodontal health, the second molar was healthier among those patients who had all of their third molar teeth removed. Compared to patients who retained at least one mandibular third molar tooth, significantly fewer patients who had all their third molar teeth removed had a periodontal depth of 4mm or more on the distal aspect of the second molar (69% and 20%, respectively). This study is clinically significant and suggests the removal of third molar teeth may improve the periodontal status in young adults with periodontal disease in the third molar area. My explanation eliminated the patient's skepticism.
Gerald S. Fine, D.D.S.
Practice limited to oral & maxillofacial surgery