Third molar surgery

Question 1

What must the clinician remind the patient when managing third molars

Answer 1

the current symptom and disease status may change over time
treatment options and risk may also change accordingly

Question 2

what are the montgomery principles

Answer 2

patients need to be made aware of the benefits and risk of each of the tx options for them to decide which option they wish to take, this includes non-surgical tx

Question 3

what 4 factors shoudl be taken into account regarding mandibular third molars

Answer 3

• patient age and medical status
• risk of complications (e.g. risk of inferior alveolar nerve injury, risk of leaving mandibular third molars in situ)
• patient access to appropriate tx (e.g. army personnel on long deployment)
• opposing third molar/contralateral third molar status, if patient is undergoing a general anaesthetic

Question 4

the likelihood that disease will develop is categorised into what 2 things by the clinician

Answer 4

high risk
low risk

Question 5

what should be done if there is a high risk of disease development and the tooth is asymptomatic

Answer 5

surgical intervention should be considered
BUT if higher risk of surgical complications, active surveillance is recommended until symptoms develop/early disease progression seen

Question 6

when is there a high risk of surgery o m3m

Answer 6

close to inferior alveolar nerve

Question 7

what should be done if there is a low risk of disease development and the tooth is asymptomatic

Answer 7

• clinical review
• radiographic assessment
• assess risk of disease