There are also risks associated with the need for general anæsthesia in some of these procedures, including rare and unpredictable death. Such patients are therefore being exposed to the risk of undertaking a surgical procedure unnecessarily.
These were superseded, legally and clinically by the NICE Guidelines. NICE states that their guidelines take precedence over other guidelines. Unfortunately, even though the NICE Guidelines have been extant since 2000, Dentists, Oral Surgeons and Maxillofacial Surgeons seem to have problems with them.
The Oral & Maxillofacial Surgeons (often consultants looking to their private practice) will 'cherry pick' from all 3 sets of guidelines.
Some dentists refer in patients for a 'job-lot' removal of all 3rd molars (often seen with South African and Antipodean dentists) even though the clinical need doesn’t warrant it.
Upper wisdom teeth and / or if the patient is having a General Anæsthetic (GA) to remove wisdom tooth / teeth, seems to be a conundrum for some clinicians.
What is often cited is, that if the patient is having a GA, then the upper ones should be removed as well as the lower ones.
The upper 3rd molars, once the lower ones have been removed, may do one of 3 things:
1. Nothing 2. Start to erupt and then ‘run out of steam’ or 3. Erupt and start to traumatise the lower mucosa.
When the latter stage has been arrived at, then I think you should consider removal of the upper 3rd molar.
Also, there is the argument that the upper third molar is functionless and hence should be removed. Why? Is there an indication for this in the guidelines? Is it due to a wish to tidy things up? Often, the rationale is again for prophylactic reasons.
Other dentists refer patients in as they have developed lower incisor crowding. There is no evidence to show wisdom teeth cause this crowding or that the crowding will be relieved by the removal of the wisdom teeth (which is presumably why in the NICE guidance, there is no orthodontic indication for Wisdom Tooth removal).