Pathology related to third molars in the elderly persons

Abstract

Objectives: The objective of this study was to clarify the discrepancy of pathology between earlier and recent studies related to third molars in the elderly persons. Evidence of third molars in the elders is limited. Earlier radiographic studies show rather few pathologic findings related to third molars. Recently, clinical studies have shown totally different numbers for pathology.

Materials and methods: Participants were drawn from the population-based Helsinki Aging Study. The study included panoramic radiographs of 293 persons (mean age 79 years, SD ± 3.9 years). We examined the prevalence of third molars and associated pathology and used the chi-squared test to perform the statistical analysis.

Results: Of the whole group of elderly persons, 19% had at least one third molar. The usual dental diseases, caries and periodontal pathology (80 and 33%, respectively), were common in the third molars. The surviving third molar most often appeared in the mandible (P < 0.01), in men (P < 0.05), in the mesioangular position (P < 0.05), and far from the mandibular canal (P < 0.001). Pathology was present in every third molar, although the proportion of serious pathology (i.e., cyst and tumor), accounted for only 2% of third molars.

Conclusions: Although serious pathology related to third molars in the elders is uncommon, universal biofilm diseases (caries and periodontal pathology) widely affect third molars as well as all other teeth.

Clinical relevance: Because all of the surviving third molars of the elders were diseased, it would be justifiable to extract these teeth at a younger age.

Keywords: Elders; Molar third; Panoramic radiograph; Pathology.