Is the third molar the most frequently extracted tooth? A population-based study utilizing dental panoramic radiographs in adults

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Abstract

Objectives

The study aimed to examine the authenticity of the often-mentioned statement that the third molar is the most frequently extracted tooth. This finding has not been shown previously in a large population-based sample.

Materials and methods

Data comprised a nationally representative sample of 6082 panoramic radiographs taken from adults in the cross-sectional Health 2000 Survey. From the radiographs, all missing teeth were recorded. Information on congenital agenesis of individual teeth was retrieved from two published meta-analyses. Primary outcome was the frequency of missing teeth by tooth type. Explanatory variables were age, sex, and the jaw (maxilla/mandible). Statistical analyses included χ ² test and binomial logistic regression.

Results

Mean age of participants (46% men, 54% women) was 53 years (SD 14.6; range 30‒97 years). Missing teeth occurred more often in women than in men ( P < 0.001). The third molar was most frequently missing and the canine least frequently. In the maxilla and mandible, the third molar was missing more often than each of the other tooth types up to the age of 80 years ( P < 0.01).

Conclusions

When considering the rates of congenital agenesis of individual teeth, it is concluded that the third molar remained the most common tooth extracted up till the age of 80 years.

Clinical relevance

The third molar is the most common target for extraction, but also the most common tooth associated with malpractice claims, and therefore, calls for skills, adequate equipment, and other resources for a successful extraction.

Related collections

Most cited references 21

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A meta-analysis of the prevalence of dental agenesis of permanent teeth.

A. L. Hof, Sven P. F. I. van Ommeren, Robert Kuijpers … (2004)

To gain more insight into the prevalence of dental agenesis. Data from Caucasian populations in North America, Australia and Europe were included in a meta-analysis. For the prevalence of African American, Chinese and Arab groups only indications could be reported because of a limited number of studies. Agenesis differs by continent and gender: the prevalence for both sexes was higher in Europe (males 4.6%; females 6.3%) and Australia (males 5.5%; females 7.6%) than for North American Caucasians (males 3.2%; females 4.6%). In addition, the prevalence of dental agenesis in females was 1.37 times higher than in males. The mandibular second premolar was the most affected tooth, followed by the maxillary lateral incisor and the maxillary second premolar. The occurrence of dental agenesis was divided into three main groups: common (P2(i) > I2(s) > P2(s)), less common (I1(i) > I2(i) & P1(s) > C(s) & M2(i)) and rare (M2(s) & M1(s) > C(i) > M1(i) & I1(s)). Unilateral occurrence of dental agenesis is more common than bilateral occurrence. However, bilateral agenesis of maxillary lateral incisors is more common than unilateral agenesis. The overall prevalence of agenesis in the maxilla is comparable with that in the mandible, but a marked difference was found between both jaws regarding tooth type. Absence of one or two permanent teeth is found in 83% of the subjects with dental agenesis. A practical application of the results of the meta-analysis is the estimation of dental treatment need. Copyright Blackwell Munksgaard, 2004

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Morphologic and Demographic Predictors of Third Molar Agenesis: A Systematic Review and Meta-analysis.

K. CARTER, S Worthington (2015)

We aimed to consolidate all available data on worldwide third molar agenesis frequencies, with a particular emphasis on exploring the factors leading authors to find contradictory results for the demographic and morphologic predictors of this anomaly. A total of 12,376 studies were originally identified, then narrowed down to 1,312 for title/abstract screening. On the basis of our inclusion and exclusion criteria, we selected 92 studies, containing 100 effect sizes and 63,314 subjects, for systematic review and metaregression. The worldwide rate of agenesis was found to be 22.63% (95% confidence interval = 20.64% to 24.76%), although the estimates ranged from 5.32% to 56.0%. Our subgroup analyses revealed that women are 14% more likely than men to have agenesis of ≥1 third molars and that maxillary agenesis was 36% more likely than mandibular agenesis in both sexes. Furthermore, we found that having agenesis of 1 or 2 molars was most common, while agenesis of 3 or 4 molars was least common. Finally, we found large differences among agenesis frequency depending on geographic region. This information is expected to be of use not only to clinicians and patients but also to policy makers, given the implications for third molar extraction protocols.

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The prevalence of third molars in a Swedish population. An epidemiological study.

F Kugelberg, A Hugoson (1988)

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Author and article information

Contributors

Irja Ventä: irja.venta@helsinki.fi

Journal

Journal ID (nlm-ta): Clin Oral Investig

Journal ID (iso-abbrev): Clin Oral Investig

Title: Clinical Oral Investigations

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 1432-6981

ISSN (Electronic): 1436-3771

Publication date (Electronic): 24 July 2024

Publication date PMC-release: 24 July 2024

Publication date (Print): 2024

Volume: 28

Issue: 8

Electronic Location Identifier: 443

Affiliations

[1 ]Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, ( https://ror.org/040af2s02) Helsinki, Finland

[2 ]Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, ( https://ror.org/02e8hzf44) Helsinki, Finland

[3 ]Institute of Dentistry, University of Eastern Finland, ( https://ror.org/00cyydd11) Kuopio, Finland

[4 ]Oral and Maxillofacial Teaching Unit, Kuopio University Hospital, ( https://ror.org/00fqdfs68) Kuopio, Finland

[5 ]Public Health Evaluation and Projection Unit, The Finnish Institute for Health and Welfare, ( https://ror.org/03tf0c761) Helsinki, Finland

Article

Publisher ID: 5845

DOI: 10.1007/s00784-024-05845-6

PMC ID: 11269347

PubMed ID: 39046553

SO-VID: a9d6a667-d7f5-4fdb-974b-d23085082131

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 17 June 2024

Date accepted : 18 July 2024

Funding

Funded by: University of Helsinki (including Helsinki University Central Hospital)

Open Access :

Open Access funding provided by University of Helsinki (including Helsinki University Central Hospital).

Custom metadata

ScienceOpen disciplines: Dentistry

Keywords: third molar,panoramic radiography,tooth extraction,adults,population characteristics

Data availability: