INDICATION OF THIRD MOLAR REMOVAL

The lower third molar or else known as the wisdom tooth is commonly causing problem to us and usually require extraction (removal). The common problems may include pain, inflammation on that side and impaction with the adjacent tooth. Therefore many people will ask for its removal just for the sake of removing the discomfort. However, not many may know that there are few things we will look for in terms of criteria to be fulfil or indications in order to remove the wisdom tooth. This is what I call "The Seventeen Commandment in Removing the Wisdom Tooth".

One; overt or recurrent history of pericoronitis (infection of the gum area around the wisdom tooth which caused by bacteria "infestation" on the area of impaction - possibly the strongest point for indication especially if the recurrence exceed three times in a year)

Two; untreatable caries on the impacted third molar or on the wisdom tooth itself

Three; untreatable pulp and periapical pathology (any disease within the wisdom tooth itself)

Four; cellulitis, abscess and osteomyelitis associated with the tooth (indicating spreading of infection into surrounding tissues originated from the tooth)

Five; periodontal disease (gum problem which in severe form)

Six; orthodontic abnormalities (the arrangement of tooth involving the wisdom tooth is unsatisfactory or may interrupted the treatment when patient is on braces)

Seven; prophylactic removal in special medicine or surgical condition (usually upon referral from other medical line for routinely clearance of bacteria source from mouth before undergoes a major surgery or treatment)

Eight; facilitation of restorative treatment (if removal of the tooth may help in restoring the other carious teeth nearby)

Nine; resorption of tooth or the adjacent tooth (if radiographically evidence show a root or other tooth structure disappearance)

Ten; pain on the tooth itself

Eleven; tooth in line of bony fracture or impeding trauma (in case where the wisdom tooth is located near or at the area of bone fracture line due to accident)

Twelve; fracture of the tooth itself (almost similar point to the above)

Thirteen; disease of follicle including tumour or cysts (if there is some changes or formation of tumour around the tooth that origin from it)

Fourteen; tooth impeding orthognathic surgery or reconstructive surgery (almost similar point with no. 6)

Fifteen; tooth invaded in or within the field of tumour (almost similar point with no. 13, only it may not neccessary originated from the tooth)

Sixteen; caries on distal of the second molar (should be another strong point where caries is found on site of impaction by wisdom tooth which always crashed into the crown or root of the adjacent tooth)

Seventeen; satisfactory tooth for donor in transplantation (should be an interesting topic where not many people may aware it!!)

I guess there are more....haha!! Oucchhh!!!!