Thesis
Trends in third molar extractions utilizing BigMouth
University of Iowa
Master of Science (MS), University of Iowa
Spring 2025
DOI: 10.25820/etd.007933
Abstract
Objective
Wisdom tooth extraction, typically performed by oral and maxillofacial surgeons, is commonly recommended due to the associated risks of tooth impaction. The American Dental Association estimates that 10 million third molars are removed annually in the U.S., affecting around 5 million patients. Despite the high number of extractions, comprehensive studies quantifying the distribution of third molars in larger populations are lacking. Our preliminary study characterized third molar extraction trends at the University of Iowa College of Dentistry. We now endeavor to gather more data through BigMouth in order to learn about the distribution of third molar extractions nationwide.
Materials and Methods
We retrieved data from Axium for third molar extractions (2008-2023) in the Department of Oral & Maxillofacial Surgery, resulting in 21,161 patients and 69,171 extracted teeth. Using six CDT codes (e.g., D7140, D7240), we categorized extractions by tooth type, age, gender, and location (maxillary vs. mandibular). To increase the sample size, we utilized BigMouth, allowing for a broader analysis of third molar distribution. Our data request resulted in 417,102 third molars and 167,833 patients included in our study.
Results
In our larger sample, there was an even distribution between impacted and erupted third molars overall. However, mandibular third molars were more frequently impacted, whereas maxillary molars were more often fully erupted at the time of extraction. Impacted molars were generally removed at a younger age compared to erupted ones. Additionally, female patients exhibited a slightly higher impaction rate and tended to undergo extractions at an earlier age than male patients. The average and mode age remained consistent over the 16-year period studied.
Conclusion
Our study included 167,883 patients and analyzed 417,102 third molar extractions. We found that mandibular third molars exhibited a higher impaction rate compared to maxillary third molars. The average age for third molar removal was 30.98 years for females and 35.2 years for males, although the mode is likely closer to 18–20 years old. The most common extraction code in the mandible was D7240 (complete bony impaction), while in the maxilla it was D7140 (extraction of an erupted tooth). Although the clinical presentation at the time of extraction was not documented, these trends provide valuable insight into impaction rates for third molars in the United States.
Details
- Title: Subtitle
- Trends in third molar extractions utilizing BigMouth
- Creators
- Kathryn P. Jehle
- Contributors
- Steven Marshall (Advisor)Kyungsup Shin (Committee Member)Lina Moreno (Committee Member)Thomas Southard (Committee Member)
- Resource Type
- Thesis
- Degree Awarded
- Master of Science (MS), University of Iowa
- Degree in
- Orthodontics
- Date degree season
- Spring 2025
- DOI
- 10.25820/etd.007933
- Publisher
- University of Iowa
- Number of pages
- xii, 53 pages
- Copyright
- Copyright 2025 Kathryn P. Jehle
- Language
- English
- Date submitted
- 04/21/2025
- Description illustrations
- Illustrations, tables, graphs, charts
- Description bibliographic
- Includes bibliographical references (pages 50-53).
- Public Abstract (ETD)
Wisdom teeth, also called third molars, are the last teeth to come in during adulthood. However, many people don’t have enough space in their mouths for these teeth to erupt properly. Because of this, wisdom teeth often get impacted, meaning they don’t fully come through the gums or bone. Since this happens so often, dentists sometimes recommend removing them early to avoid future problems.
Wisdom teeth removal is one of the most common surgeries for teenagers and young adults, but there hasn’t been much large-scale information about how and when these teeth are removed in the United States. In this study, we utilized a dental database called BigMouth to evaluate a large sample of patients that included 167,883 patients who had a total of 417,102 wisdom teeth taken out.
Using dental records through the BigMouth database, we gathered information about each patient’s age, gender, and whether the tooth was in the top jaw (maxilla) or lower jaw (mandible). We also recorded whether the tooth had fully come in or was still impacted under the gums and bone.
We found that most people had one or four of their wisdom teeth removed. Wisdom teeth in the lower jaw were more likely to be impacted compared to the upper jaw. Impacted wisdom teeth were usually removed at a younger age than fully grown ones. Also, females tended to have a slightly higher rate of impacted teeth and usually had their wisdom teeth removed at a younger age than males.
- Academic Unit
- Orthodontics; Craniofacial Anomalies Research Center
- Record Identifier
- 9984830924002771
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