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Overview
An article published in the September 20 issue of the Washington Post  1 reports that adults with third molars often develop gum disease, which may cause further health risks. The report is based on four longitudinal studies that will be published in an upcoming issue of the Journal of Oral and Maxillofacial Surgery.
In the studies, the investigators evaluated signs of periodontal disease in reportedly asymptomatic third molars of young adults aged 20-35, including probing depth, radiographic examination, inflammatory mediators, or levels of pathogenic organisms. Collectively, the study results indicate that there may be a higher incidence of periodontal disease associated with asymptomatic third molars in this age group than had been expected.
The authors extrapolate that the oral inflammation associated with periodontal disease of third molars may make young adults at increased risk for inflammation throughout the body, placing these patients at risk for numerous systemic diseases. This hypothesis is based on numerous studies that have indicated that there may be a relationship between oral disease, including periodontal (gum) disease, and systemic conditions, such as cardiovascular disease, diabetes and adverse pregnancy outcomes. However, such relationships have not been definitively established, and causality has not been determined.
Of the four studies, only one directly addressed the relationship between periodontal disease of third molars and a systemic condition. In this study, the association between periodontitis, including third molars, of pregnant women and preterm birth (<37 weeks) was evaluated. Periodontitis was associated with preterm birth, especially if the periodontal condition of third molars was included in the evaluation. This study suggests that there may be a relationship between maternal periodontal disease and adverse pregnancy outcomes.
These longitudinal studies reinforce the need to assess the periodontal status of third molars. While one study addressed the possibility that maternal periodontal disease of third molars may be related to preterm delivery, the other studies did not directly assess possible relationships between periodontal disease and systemic conditions. Additional studies are needed to confirm these relationships and determine causality. The ADA will continue to monitor research on this topic and offer appropriate recommendations to the profession as needed.
The ADA recommends that periodontal evaluation be done as part of a routine adult oral exam. When considering extraction of third molars, other factors, such as general health, caries, oral hygiene, position, other possible pathologies, and patient preferences should also be addressed. In addition, patients should be made aware of the importance of oral health, and be encouraged to practice good oral hygiene and visit their dentist regularly.
1 Stein R. Adults With Wisdom Teeth Often Develop Gum Disease. The Washington Post. September 20, 2005.
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A–Z Topic: Periodontal Diseases
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Science in the News is a service by the American Dental Association (ADA) to present current information about science topics in the news. The ADA is a professional association of dentists committed to the public's oral health, ethics, science and professional advancement; leading a unified profession through initiatives in advocacy, education, research and the development of standards. As a science-based organization, the ADA's evaluation of the scientific evidence may change as more information becomes available. Your thoughts would be greatly appreciated.
Document Posted September 2005
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