Long-term evaluation of estimates of need for third molar removal

Purpose: The aim of this study was to evaluate the estimates on need for third molar removals made at age 20 after 12 years. Patients and Methods: The series consisted of 81 university students followed from age 20 to 32 years. At baseline and at study end, these students were clinically examined, and panoramic radiographs were taken. At baseline in 1982, a qualified oral surgeon had made estimates on need for removal of third molars within 5 years; 75% of students needed removals. Actual treatment performed was evaluated after 12 years. A questionnaire served to determine symptoms related to third molars during the 12-year period. Results: During the follow-up, one or more third molars had been removed from 67% of the former students. A total of 155 third molar removals had been estimated, but by age 32 years the percentage actually removed was only 59%. Of the 79 third molars taken out at the Finnish Student Health Service, 77% were initially estimated to need a surgical procedure, but actually 66% were simply extracted. Most were removed at around age 27 years. According to the questionnaire, 67% of the students were asymptomatic in the third molar region during 12 years. Conclusion: Because need for surgical removal decreases during early adulthood, routine prophylactic extraction of asymptomatic third molars in young adults cannot be recommended. Well-defined indications for prophylactic removals are needed.