8 - Third molars 3 Flashcards

1
Q

What are the common treatment options for third molars?

A
  • referral
  • clinical review (monitor)
  • removal of M3M
  • extraction
  • coronectomy
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2
Q

What are the less common treatment options for third molars?

A
  • operculectomy
  • surgical exposure
  • pre-surgical orthodontics
  • autotransplantation
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3
Q

What is involved in decision making surrounding third molars?

A
  • patient involvement (informed consent)
  • good note taking
  • current status of patient and M3M
  • risk of complications
  • patient access to treatment
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4
Q

What is active surveillance?

A

Regular radiographs

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5
Q

What is clinical review?

A

Monitor clinically without radiographs

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6
Q

What anaesthesia options are available for extraction of third molars?

A
  • LA alone
  • conscious sedation
  • GA
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7
Q

What consent is required for GA sedation?

A

Written consent form

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8
Q

What consent is required for IV sedation?

A

Written consent form

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9
Q

What consent is required for LA?

A

Written consent form is best practice although some areas use a sticker in the notes signed by the patient

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10
Q

What are the common post operative complications of extraction of third molars?

A
  • pain
  • swelling
  • bruising
  • jaw stiffness
  • bleeding
  • infection
  • dry socket
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11
Q

What must you warn the patient about nerve damage?

A
  • numbness is more common that tingling
  • the lower lip, chin and side of tongue can be affected
  • this is a change in sensation not function or appearance
  • temporary around 10-20%
  • permanent <1%
  • can also experience altered taste although rare
  • risk is higher is the tooth is close to the nerve
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12
Q

How long can nerves recover for?

A

18-24 months although after this period there is not much hope for further recovery

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13
Q

When should a patient be offered a CBCT before third molar surgery?

A
  • if the third molar roots appear in close proximity to the ID canal
  • should only be offered if the scan could change the treatment plan, ie if the crown is grossly carious the tooth is not suitable for coronectomy
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