NICE and the third molar debate

In 2000 the National Institute for Health and Care Excellence (NICE) published clinical guidance that advised against the removal of disease-free wisdom teeth (prophylactic removal).1 This was mainly driven by the perception in the UK that up to 44% of all removed third molars were disease free and consequently had no clinical indication for removal.1,2 But does the NICE guidance, which has become akin to scripture on this issue, have everything right?.

[1]  S. Falci,et al.  Association between the presence of a partially erupted mandibular third molar and the existence of caries in the distal of the second molars. , 2012, International journal of oral and maxillofacial surgery.

[2]  T. Renton,et al.  The effects of NICE guidelines on the management of third molar teeth , 2012, BDJ.

[3]  A. Plasschaert,et al.  Surgical removal versus retention for the management of asymptomatic impacted wisdom teeth. , 2012, The Cochrane database of systematic reviews.

[4]  I. Ozeç,et al.  Prevalence and factors affecting the formation of second molar distal caries in a Turkish population. , 2009, International journal of oral and maxillofacial surgery.

[5]  Seok-Woo Chang,et al.  Correlation study between distal caries in the mandibular second molar and the eruption status of the mandibular third molar in the Korean population. , 2009, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[6]  G. Mathew,et al.  The mesioangular third molar – to extract or not to extract? Analysis of 776 consecutive third molars , 2009, BDJ.

[7]  J. Friedman.  The prophylactic extraction of third molars: a public health hazard. , 2007, American journal of public health.

[8]  R. Haug,et al.  Chronic oral inflammation and the progression of periodontal pathology in the third molar region. , 2006, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[9]  T. Renton,et al.  Distal cervical caries in the mandibular second molar: an indication for the prophylactic removal of the third molar? , 2006 .

[10]  R. Haug,et al.  Progression of periodontal disease in the second/third molar region in subjects with asymptomatic third molars. , 2006, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[11]  J. Beck,et al.  Third molars associated with periodontal pathology in older Americans. , 2005, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[12]  S. Offenbacher,et al.  Poster 22: Association of third molars with periodontal pocketing: The dental ARIC study , 2004 .

[13]  R. Haug,et al.  Periodontal pathology associated with asymptomatic third molars. , 2002, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[14]  S. Worrall,et al.  UK National Third Molar project: the initial report. , 1998, The British journal of oral & maxillofacial surgery.