8 - Third molars 3 Flashcards
What are the common treatment options for third molars?
- referral
- clinical review (monitor)
- removal of M3M
- extraction
- coronectomy
What are the less common treatment options for third molars?
- operculectomy
- surgical exposure
- pre-surgical orthodontics
- autotransplantation
What is involved in decision making surrounding third molars?
- patient involvement (informed consent)
- good note taking
- current status of patient and M3M
- risk of complications
- patient access to treatment
What is active surveillance?
Regular radiographs
What is clinical review?
Monitor clinically without radiographs
What anaesthesia options are available for extraction of third molars?
- LA alone
- conscious sedation
- GA
What consent is required for GA sedation?
Written consent form
What consent is required for IV sedation?
Written consent form
What consent is required for LA?
Written consent form is best practice although some areas use a sticker in the notes signed by the patient
What are the common post operative complications of extraction of third molars?
- pain
- swelling
- bruising
- jaw stiffness
- bleeding
- infection
- dry socket
What must you warn the patient about nerve damage?
- numbness is more common that tingling
- the lower lip, chin and side of tongue can be affected
- this is a change in sensation not function or appearance
- temporary around 10-20%
- permanent <1%
- can also experience altered taste although rare
- risk is higher is the tooth is close to the nerve
How long can nerves recover for?
18-24 months although after this period there is not much hope for further recovery
When should a patient be offered a CBCT before third molar surgery?
- if the third molar roots appear in close proximity to the ID canal
- should only be offered if the scan could change the treatment plan, ie if the crown is grossly carious the tooth is not suitable for coronectomy
