012: Risk Factors For Infection After Third Molars Surgery

Risk Factors for Post-Op Infection in Third Molar Extractions

Hey everyone, it's your host, Russell, here. In this episode, I want to share with you an interesting article I came across in the Journal of Stomatology Oral Maxillofacial Surgery, published just a few days ago on March 21, 2024. The article is titled "Risk factors for post-extraction infection of mandibular third molar: a retrospective clinical study" by Muka Naka et al., out of Japan.

Key takeaways:
- This large-scale retrospective study looked at 2,513 third molar extraction cases over 8 years (2014-2022) at a single facility in Kobe, Japan
- The overall post-op infection rate was 5.73% (144 out of 2,513 cases)
- Risk factors for increased post-op infection included:
- Age over 36 (risk increased with each additional year of age)
- Pre-op infection/inflammation (patients given pre-op antibiotics had higher infection rates, likely because infection was already present)
- Post-op paresthesia (suggests more difficult surgery)
- Need for intraoperative hemostatic procedures
- More severe impaction (deeper impactions on Pell & Gregory scale, horizontal/inverted on Winter's classification)
- Delayed treatment in older patients allows more time for disease processes to occur around third molars
- Increased bone density with age makes extractions more difficult

I believe this provides more rationale for preventively removing wisdom teeth in younger, healthier patients rather than waiting until issues arise later in life. While there is controversy over prophylactic third molar removal, avoiding the increased surgical risks and prolonged recovery in older patients is a compelling argument in favor of earlier intervention when indicated.

I hope you found this information interesting and useful. Feel free to reach out to me at [email protected] with any questions. Have a great week!