Management of unerupted and impacted third molar teeth. A National Clinical Guideline

Abstract

AIM: To assist individual clinicians, hospital departments, hospitals and commissioners of health care to produce local guidelines for the identification of patients who might benefit most from removal of unerupted third molar teeth and those for whom removal is not necessary. DEVELOPMENT: The guideline was developed in accordance with a process developed by the Scottish Intercollegiate Guidelines Network (SIGN). SIGN is an initiative established in 1993 by the Conference of Royal Colleges and their Faculties in Scotland to sponsor and support the development of national guidelines on a multi-professional basis. Following a systematic review of the literature a development group produced a guideline with recommendations based on the evidence levels set out by the US Agency for Health Care Policy and Research (Table 1). All SIGN guidelines are produced with a summary document, together with more details of the evidence supporting the recommendations. The detailed section of this guideline runs to some 36 pages. RECOMMENDATIONS: The guideline provides recommendations relating to when it is and is not advisable to remove wisdom teeth as well as including some strong and other indications for their removal. It also provides advice for the clinical and radiographic assessment of third molars. There is also a grade B recommendation that there is no need for routine radiographic assessment of the unerupted third molar. REVIEW DATE: This guideline was issued in 2000 and will be reviewed in 2002 or sooner if new evidence becomes available. Any updates to the guideline in the interim period will be noted on the SIGN website (http://www. sign.ac.uk)