References

Donnell CC, Clark MV Mandibular third molars: ‘naughty’ or NICE?. Br Dent J. 2020; 228:506-507 https://doi.org/10.1038/s41415-020-1433-x
National Institute for Health and Care Excellence. Review of TA1. Guidance on the extraction of wisdom teeth. 2015. http://www.nice.org.uk/guidance/ta1/resources/wisdom-teeth-removal-appendix-a-rppdecision-paper-march-20152 (accessed January 2021)
McArdle LW, Renton T The effects of NICE guidelines on the management of third molar teeth. Br Dent J. 2012; 213 https://doi.org/10.1038/sj.bdj.2012.780
Hounsome J, Pilkington G, Mahon J Prophylactic removal of impacted mandibular third molars: a systematic review and economic evaluation. Health Technol Assess. 2020; 24:1-116 https://doi.org/10.3310/hta24300
FDS RCS parameters of care for patients undergoing third molar surgery 2020. http://www.rcseng.ac.uk/dental-faculties/fds/publications-guidelines/clinical-guidelines/ (accessed May 2021)

Authors

Tara Renton

BDS, MDSc, PhD

Professor of Oral Surgery, King's College London; Honorary Consultant in Oral Surgery, King's College Hospital NHS Foundation Trust and Guy's and St Thomas' NHS Foundation Trust, London

Articles by Tara Renton

R Cruickshank

Dental Core Trainees, Scotland

Articles by R Cruickshank

A Crummey

BDS, MFDS, PGCert

Dental Core Trainees, Scotland

Articles by A Crummey

VH Muir

Dental Core Trainees, Scotland

Articles by VH Muir

P Dhanrajani

HCF Dental Centre, Sydney, Australia

Articles by P Dhanrajani

M Smith

HCF Dental Centre, Sydney, Australia

Articles by M Smith

T Rynberg

HCF Dental Centre, Sydney, Australia

Articles by T Rynberg

Mark J Bishop

Clinical Teacher in Adult Unit of Restorative Dentistry, University of Sheffield

Articles by Mark J Bishop

Vathana Ketheeswaranathan

University Hospital

Articles by Vathana Ketheeswaranathan

Kavin Andi

Consultant Oral and Maxillofacial Surgeon St Georges Hospital, Croydon University Hospital

Articles by Kavin Andi

Rajiv S Desai

Professor & Head, Department of Oral Pathology, Nair Hospital Dental College, Mumbai Central, Mumbai 400008, India

Articles by Rajiv S Desai

Shivani P Bansal

Professor (Additional), Nair Hospital Dental College, Mumbai India

Articles by Shivani P Bansal

Pankaj M Shirsat

Associate Professor, Nair Hospital Dental College, Mumbai India

Articles by Pankaj M Shirsat

Pooja Prasad

Assistant Professor, Department of Oral Pathology, Nair Hospital Dental College, Mumbai Central, Mumbai 400008, India

Articles by Pooja Prasad

Sonal S Dhanawade

Postgraduate student, Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Mumbai India

Articles by Sonal S Dhanawade

Karen Paterson

CDF Pastoral Care Scheme Coordinator, Christian Dental Fellowship

Articles by Karen Paterson

Ellen Louise Johnson

Plumstead Dental Surgery, 8–14 Herbert Road, London, SE18 3SH

Articles by Ellen Louise Johnson

Article

It is estimated that approximately half a million third molars are extracted every year in the UK (L McArdle, personal communication). In April 2020, Donnell and Clark in ‘Naughty or NICE?’1 highlighted a significant shortcoming of the 2000 NICE guidance on extraction of wisdom teeth: second molar caries.2 Previous papers report additional issues, including the impact of delayed surgery and resultant increased surgical morbidity.3

A health technology assessment was undertaken to review the NICE guidance published in 2020, concluding that ‘The evidence comparing the prophylactic removal of impacted mandibular third molars with retention and standard care is very limited. However, the results from an exploratory assessment group model, which uses available evidence on symptom development and extraction rates of retained impacted mandibular third molars, suggest that prophylactic removal may be the more cost-effective strategy’.4

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