New considerations in the treatment of compromised third molars.

Management of asymptomatic malposed third molars is a controversial topic. As a result, many malposed or mildly pathologic third molars are not removed. Historical pro and con arguments regarding removal centered around cost and the aspects of the surgical removal itself. Current epidemiology and medical advances address issues not considered before. There is a large growth of the aging population (over 40 years). More and more of these elderly patients are requiring third molar removal. Over a five-year period, 1997-2002, the incidence almost doubled to 17.9 percent. This age category is known to be high risk for third molar surgery. An equally or higher risk is the rapidly growing number of patients seeking third molar surgery who are moderately severely medically compromised. This paper reviews how this lack of consensus results in delayed removal of malposed third molars in this population. Preventive dental concepts, removing compromised third molars earlier, would eliminate the high risk to this aging population.