Patient preference for the management of mandibular third molars with mesio-angular and horizontal impactions

Abstract

Background Mesio-angular and horizontal mandibular third molars (M3Ms) are a risk factor for the development of dental disease, particularly affecting mandibular second molars (M2Ms). The aim of this study was to gain an insight into patient knowledge, views and opinions on management of disease-free horizontal and mesio-angular M3Ms. Methods Adult patients with at least one horizontal or mesio-angular M3M with an adjacent M2M attending an oral and maxillofacial surgery clinic were invited to participate in a structured survey. Results From 400 responses, 64% (n = 257) of respondents stated they would choose to have their impacted M3M prophylactically removed given the hypothetical scenario that they have never experienced any symptoms from their wisdom tooth. Of patients that never experienced symptoms from their wisdom teeth, 39.1% (n = 43) selected prophylactic removal, compared with 73.8% (n = 214) of patients that had previously experienced symptoms (χ2 = 40.3; p <0.001). The extent of disease progression significantly influenced patient preference for surgery (χ2 = 55.173; p <0.001), as did age (χ2 = 28.28; p <0.001). Conclusion In most cases, symptoms, age and disease experience influenced patients'' treatment preferences. These findings support the importance of discussion and shared decision-making in the consent process.