Professional Documents
Culture Documents
Management of Third Molar Teeth was developed by the American Association of Orthodontists (AAO)
American Association of Oral and Maxillofacial Surgeons American College of Oral and Maxillofacial Surgeons
(AAOMS) and is supported by the following organizations: (ACOMS)
American Academy of Oral and Maxillofacial Pathology British Association of Oral and Maxillofacial Surgeons
(AAOMP) (BAOMS)
American Academy of Oral and Maxillofacial Radiology British Association of Oral Surgeons (BAOS)
(AAOMR) Canadian Association of Oral and Maxillofacial Surgeons
American Academy of Pediatric Dentistry (AAPD) (CAOMS)
American Academy of Periodontology (AAP) International Association of Oral and Maxillofacial
American Association of Endodontists (AAE) Surgeons (IAOMS)
The American Association of Oral and Maxillofacial therefore given the desire to achieve therapeutic
Surgeons believes the best approach to any clinical goals, obtain positive outcomes, and avoid known
dilemma is to employ “evidence based practice.” risks and complications, a decision should be made
This process merges the best available clinically before the middle of the patient’s third decade to
relevant evidence with the results of a comprehensive remove or continue to observe third molars, with the
and focused clinical and imaging examination to knowledge that future treatment may be necessary
formulate recommendations that can be discussed based on the clinical situation. Finally, the AAOMS
with the individual patient. also recognizes the oral and maxillofacial surgeon as
the clinician qualified to determine a surgical treatment
A common clinical dilemma faced by patients today is plan and care for the individual patient.
what to do about their third molars. Areas of concern
include determining when surgical management is AAOMS Position Statement on
indicated (particularly in the case of “asymptomatic” Third Molar Management
teeth), the risks associated with either removal or retention
of third molars, the optimal timing for treatment, the cost As a means of helping to clarify what is known with
of treatment as well as the cost of retention, and how to respect to third molar management, the AAOMS offers
best develop a plan for follow-up when a decision is made the following position statement:
to retain a third molar. Predicated on the best evidence-based data,
There are a variety of recognized management choices third molar teeth that are associated with disease,
for third molars, including removal, partial removal or are at high risk of developing disease, should
(coronectomy), retention with active clinical and be surgically managed. In the absence of disease
radiographic surveillance, surgical exposure, tooth or significant risk of disease, active clinical and
repositioning, transplantation, surgical periodontics, radiographic surveillance is indicated.
and marsupialization of associated soft tissue pathology This statement clearly recognizes that while not all
with observation and possible secondary treatment. third molars require surgical management, given the
When considering possible management choices, documented high incidence of problems associated
the clinician should also consider the likelihood with third molars over time, all patients should be
that disease will develop. Further, evidence clearly evaluated by someone experienced and expert in
indicates that surgery is more difficult as patients age; third molar management.