Dentists' decisions on prophylactic removal of mandibular third molars: a 10-year follow-up study.
OBJECTIVE
In recent years, several critical outcome studies concerning the prophylactic removal of mandibular third molars have been published. These would appear to motivate a more restrictive approach today as compared with 10 years ago. The aim of the present study was to examine dentists' decisions on the prophylactic removal of impacted mandibular third molars over a 10-year period.


METHODS
Thirty-six cases were selected so as to represent an equal distribution of males and females, ages, angular position and degree of impaction of the molar. Twenty-six general dental practitioners (GDPs) and 10 oral surgeons judged the same cases on two occasions 10 years apart.


RESULTS
Calculated for each category of dentists, there was no significant difference in the mean number of molars designated for removal between the two occasions. Two GDPs and three oral surgeons presented a higher removal rate, whereas five GDPs presented a lower removal rate on the second occasion as compared to the first one. The dentists presented a considerable interindividual variation in removal rate, between 0 and 22 molars on the first occasion and between 0 and 25 molars on the second occasion.


CONCLUSIONS
In the decisions on prophylactic removal of mandibular third molars, there has been no change over the last 10 years towards a more noninterventionist attitude. Thus, the dentists seem not to have been influenced by the evidence that this intervention is not cost-effective.
Knutsson
K
K
Department of Oral Radiology, Faculty of Odontology, Malmö University, Sweden. Kerstin.Knutsson@od.mah.se
Lysell
L
L
Rohlin
M
M
D000328:Adult; D001291:Attitude of Health Personnel; D003362:Cost-Benefit Analysis; D003657:Decision Making; D005260:Female; D005792:General Practice, Dental / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008334:Mandible; D008875:Middle Aged; D008964:Molar, Third / Q000601:surgery*; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D018709:Statistics, Nonparametric; D013515:Surgery, Oral / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014081:Tooth Extraction / Q000191:economics / Q000706:statistics & numerical data*; D014095:Tooth, Impacted / Q000601:surgery