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Third-molar removal patterns in an insured population.

BACKGROUND
The authors examined third-molar removal patterns in an insured population to see how these patterns compare with recommendations in the literature.


METHODS
The source of treatment data was insurance claims for services rendered from July 1991 through December 1999; it included approximately 100 million dental procedures provided to about 7.4 million patients from all 50 states. The insured were public and private employees or retirees and their dependents.


RESULTS
The authors found that third molars were the most commonly extracted permanent teeth, and they most often were removed from adolescents. Friday was the day of the week on which most extractions occurred, and the favored month was August, followed by July, December and June. Another important pattern revealed by the authors' analysis was that there was substantial variation among dental practices in whether patients had third molars removed and in the timing of the removal. They found that adolescent patients in some dental practices rarely were referred for third-molar removal, while in other practices, most or all had third molars removed.


CONCLUSIONS
Third-molar removal patterns suggest that many third molars are not removed in response to acute pathology, and the observed variation in the likelihood and timing of these extractions reflects the lack of consensus on this topic in the dental literature.


CLINICAL IMPLICATIONS
The apparent lack of consensus on third-molar removal should be resolved for the profession to maintain the confidence of the public that the recommended care is based on sound evidence.