Review of the current indications for the treatment of third molars: Based on the parameters of care

Abstract

Debate how to manage resources for patient care. While recognizing the importance and impact of health policy discussions, surgeons remain responsible for making evidence-based health care decisions in the best interest of their patients. One area of great concern for practicing clinicians is how to identify and apply appropriate indications for the management of third molar teeth, since the majority of adolescents and young adults have third molars and face the need to decide whether to have them removed or to retain them with monitoring. Intentionally or not, the line has been blurred on the difference between “coverage” provided by third party carriers and “indications”, further confusing the decision-making process.Reflecting the scope of this problem, the literature is replete with articles regarding matters related to the evaluation and management of third molar teeth. In an effort to develop some measure of consensus, the American Association of Oral and Maxillofacial Surgeons convened a workshop on the management of the patients with third molar teeth, with its report issued in the Journal of Oral and Maxillofacial Surgery in 1994. In addition, indications for therapy were included as a part of the AAOMS Parameters of Care. In an effort to utilize this and other information in presenting a coherent position to the insurance industry and others, the AAOMS Committee on Health Care Programs distilled this information into a document that outlines these indication with clinical examples of each.This presentation will review these consensus criteria and briefly comment on how they compare with other published criteria such as those contained in the British Parameters of Care and those found in textbooks on oral and maxillofacial surgery.ReferencesAmerican Association of Oral and Maxillofacial Surgeons: Report of a workshop on the management of patients with third molar teeth. J Oral Maxillofac Surg. 52:1102, 1994American Association of Oral and Maxillofacial Surgeons: Parameters and pathways: Clinical practice guidelines for oral and maxillofacial surgery. Dentoalveolar Surg 3:15, 2001Peterson LJ: Principles and management of impacted teeth, in Peterson et al: Contemporary Oral and Maxillofacial Surgery (ed 4). Pp 184–213 Debate how to manage resources for patient care. While recognizing the importance and impact of health policy discussions, surgeons remain responsible for making evidence-based health care decisions in the best interest of their patients. One area of great concern for practicing clinicians is how to identify and apply appropriate indications for the management of third molar teeth, since the majority of adolescents and young adults have third molars and face the need to decide whether to have them removed or to retain them with monitoring. Intentionally or not, the line has been blurred on the difference between “coverage” provided by third party carriers and “indications”, further confusing the decision-making process. Reflecting the scope of this problem, the literature is replete with articles regarding matters related to the evaluation and management of third molar teeth. In an effort to develop some measure of consensus, the American Association of Oral and Maxillofacial Surgeons convened a workshop on the management of the patients with third molar teeth, with its report issued in the Journal of Oral and Maxillofacial Surgery in 1994. In addition, indications for therapy were included as a part of the AAOMS Parameters of Care. In an effort to utilize this and other information in presenting a coherent position to the insurance industry and others, the AAOMS Committee on Health Care Programs distilled this information into a document that outlines these indication with clinical examples of each. This presentation will review these consensus criteria and briefly comment on how they compare with other published criteria such as those contained in the British Parameters of Care and those found in textbooks on oral and maxillofacial surgery. References American Association of Oral and Maxillofacial Surgeons: Report of a workshop on the management of patients with third molar teeth. J Oral Maxillofac Surg. 52:1102, 1994 American Association of Oral and Maxillofacial Surgeons: Parameters and pathways: Clinical practice guidelines for oral and maxillofacial surgery. Dentoalveolar Surg 3:15, 2001 Peterson LJ: Principles and management of impacted teeth, in Peterson et al: Contemporary Oral and Maxillofacial Surgery (ed 4). Pp 184–213