Prophylactic third molar extractions: US dental school departments' recommendations from 1998/99 to 2004/05

Objective: To review the recommendations by dental faculties regarding prophylactic removal of third molars (PR-3M) and to determine if the recommendations at institutions differed and whether there have been changes since 1998/99. Method and Materials: In 1998/99 and 2004/05, a questionnaire was sent to department chairpersons of oral surgery, orthodontics, and restorative dentistry/prosthodontics of US dental schools. They were asked to characterize their department's PR-3M recommendations for adolescents ( 21 years of age), young adults (21 to 35 years), and adults (> 35 years). Third molars were categorized as fully erupted, semierupted, and unerupted. Participants also were to indicate their rationale for PR-3M. Nonparametric and independent t tests were applied to the data (P = .05). Results: Response rates for 1998/99 and 2004/05 were 64% and 66%, respectively. There continues to be significant differences among the departments in PR-3M recommendations, especially for adolescents. There were fewer departmental differences for young adults and adults, with a majority recommending removal of semierupted and unerupted third molars for young adults. Of the chairpersons changing their recommendation, although not significant, more changed to remove than to retain. There was a significant decrease in recommendations to extract fully erupted third molars of young adults and adults. Nevertheless, recommendations to remove semierupted and unerupted third molars of adolescents and young adults remain high. Conclusions: The level of recommendations to electively remove third molars is inconsistent with the current nonintervention literature. Intramural departmental inconsistencies can result in confusion for students and patients. Hence, dental faculties may wish to reevaluate their curricula regarding third molar management. Keywords: department of orthodontics, department of oral surgery, department of prosthodontics, prophylactic extraction, third molars