Removal of impacted teeth

It is one of the most common oral surgery procedures. Due to the position of the 3rd molars, their emergence in the mouth is often incomplete and they remain ipacted next to the second molar or deep inside the jaw bone. When these teeth are causing problems and the benefits of removal are high, the solution is surgical extraction. The lower alveolar neurovascular bundle as well as the lingual nerve are occasionally adjacent and the risk of injury during extraction is taken into account as a risk factor depending on the case. That is why proper initial planning and assignment is critical.

Instructions for removing impacted teeth

What are the N.I.C.E instructions?

The National Institute of Clinical Perfection (N.I.C.E.) is part of the UK’s National Health System (N.H.S.) and is made up of special teams that provide instructions on medications, equipment and clinical procedures every 12 months or so to promote health care. Approvals concerning technology manufacturers, patient groups and professional organizations for whom extensive evaluations are also performed. Regarding impacted teeth extractions they provide instructions on when the procedure is performed and whether the patient can benefit from alternative therapies.

What is an impacted tooth?

Permanent teeth develop from the age of 6 onwards. The 3rd molars are the last posterior teeth and appear at the age of 18-24. However, their appearance in the mouth is usually accompanied by problems with their development. When the 3rd molar is not visible at all in the mouth it is called impacted. This is due to lack of space or because another tooth is emerging. Usually the fully impacted ones do not cause problems but when inflammation is observed in the surrounding gums they can cause tooth decay, gingivitis in surrounding areas and maybe problems with the same teeth in the future.

What does N.I.C.E. suggest?

Based on scientific data, the following suggestions regarding the removal of impacted teeth are:
Healthy impacted 3rd molars should not be operated on because there is not enough reliable scientific research to show that patients are really benefiting from their removal
Patients are exposed to risk as surgery can be relatively dangerous. However, patients with impacted teeth that do not cause problems should be checked frequently.
Only patients with impacted teeth that cause a problem or other condition in the mouth that could be affected by possible inflammation of impacted teeth should undergo a surgical removal procedure. Such conditions may include caries, cysts, pericoronitis associated with this tooth, or when the impacted tooth is in a fracture line or adjacent surgery.