third molars - tx options, anaesthesia, consent + referral Flashcards
Describe the common treatment options for third molars
Referral
Clinical review
Removal of the third molar
Coronectomy
What are the less common treatment options for third molars?
Operculectomy
Surgical exposure
Pre-surgical orthodontics
Surgical reimplantation/autotransplantation
How should decision making on treatment options for third molars involve the patient?
Should involve the patient by communicating findings, discussing risks and benefits, and obtaining consent
What are the methods of anesthesia for third molar surgery?
Local anesthesia alone
Conscious sedation
General anesthesia
What are the potential post-operative complications of third molar surgery?
Pain
Swelling
Bruising
Jaw stiffness/limited mouth opening
Bleeding
Infection
Dry socket
What are the common nerve damage symptoms associated with lower lip and chin after third molar surgery?
Numbness (anaesthesia) or tingling (paraesthesia)
What percentage of people require conscious sedation for routine dental treatment?
Approximately 7% of people require conscious sedation for routine dental treatment, which is likely higher for third molar surgery.
What should be explained to the patient regarding minor surgical procedures for third molar surgery?
The patient should be explained about the procedure, including what to expect, such as flap, possible drilling, and stitches
What is the prevalence of ID nerve damage after third molar removal?
Covers lower lip/chin
10-25% temporary nerve damage
<1% will experience permanent nerve damage
What is the Chorda Tympani?
It is a branch of the facial nerve that supplies the taste buds from the anterior two thirds of the tongue
It carries fibres via the lingual nerve
What are some other forms of nerve damage that can occur?
Dysaesthesia, reduced sensation (hypoaesthesia), and heightened sensation (hyperaesthesia)
How long can nerves take to recover after damage?
Nerves can recover up to 18-24 months after damage
When should a patient be offered a CBCT scan for third molar extraction?
If there are concerns of close proximity between the ID canal and the tooth/roots from the 2D radiograph
What are some factors that affect the decision to get a CBCT scan before third molar extraction?
It wouldn’t change the treatment provided
If the patient does not want the scan
If the patient does not want a coronectomy
If the patient wants a surgical removal regardless of the risks
If the tooth is not suitable for coronectomy
What is the recommended practice regarding discussions with patients?
Discussions with the patients must be documented
