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This transitioned us from our once tough, hard and fibrous low calorie diet to
a vastly soft and extremely calorie dense diet.
The contact area between the second and third molar is the start of a carious lesion and it is oftentimes under the
gingival margin where it is virtually impossible to be aware of unless it is seen radiographically or is causing the
patient pain or discomfort.
Unilateral impaction is much more common than bilateral impaction and also mandibular impaction is more
common than maxillary impaction.
Incidence of distal second molar caries due to
impacted third molars:
The angle at which the partially erupted third molar touches
the second molar is a determing factor as to whether the distal
second molar develops a carious lesion.
For example:
But the risk goes down if the third molar is in contact with the
distal of the second molar above the CEJ.
Most important role of all, treat each and every one of our
patients on an individualistic basis and accomodate the
dental needs tailored specifically for that patient. Everyone is
different and every case is different. Continuing Education is key
Further Research
● Ending the debate on when/if it is best to extract a person’s third
molars.
● More cost effective extraction methods
● Whether or not jaw size is a real cause of impaction or if it is the way the
soft tissue forms that is to blame.
● If genetically, there is a way to tell if someone will have impacted third
molars. And if so, if it is bilateral or unilateral or on both arches or just
one.
● Is this something that is passed down from lineage to lineage or is it
strictly based on environmental influences of the world.
References:
Almpani, K., & Kolokitha, O. (2015, February 16). Retrieved April 09, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4317606/
Campbell, John H. Pathology associated with third molar. Retrieved from: http://www.oralmaxsurgery.theclinics.com/article/S1042-
Carter, Katherine. 2016. The Evolution of Third Molar Agenesis and Impaction. Doctoral dissertation, Harvard University, Graduate School of Arts
& Sciences.
E. (2018, January 18). How the Western Diet Has Changed the Human Face. Retrieved April 09, 2018, from http://darwinian-medicine.com/how-
the-western-diet-has-changed-the-human-face/
GOYAL, S., VERMA, P., & SUNDER RAJ, S. (2016). Radiographic Evaluation of the Status of Third Molars in Sriganganagar Population -- A
Digital Panoramic Study. Malaysian Journal Of Medical Sciences, 23(6), 103-112. doi:10.21315/mjms2016.23.6.11
Campbell, John. “Pathology Associated with the Third Molar.” Pathology Associated with the Third Molar , 2013,
www.oralmaxsurgery.theclinics.com/article/S1042-3699(12)00178-1/pdf+.)
References
Huang,Cunha-Cruz,Rothen,Spiekerman, Drangsholt,Anderson,& Roset,2014). A Prospective Study of Clinical Outcomes Related to Third Molar
Knapton, S. (2017, August 25). Birth of farming caused jaw-dropping changes to the human skull, scientists find. Retrieved April 09, 2018, from
https://www.telegraph.co.uk/science/2017/08/25/birth-farming-caused-jaw-dropping-changes-human-skull-scientists/
MOLAR CARIES; DISTAL SURFACE MANDIBULAR SECOND MOLAR ... (n.d.). Retrieved April 9, 2018, from
https://www.bing.com/cr?IG=3544EA2565B349FE8775077BD87A38D4&CID=3CB3EC04C27D6C1C2C33E7C8C3D26DA2&rd=1&h=HsMCbB
AJ1Qr8qkmJB2lLd57CsCQADCj0NPWaqFKE8Aw&v=1&r=https://www.researchgate.net/publication/319014216_MOLAR_CARIES_DISTAL_
SURFACE_MANDIBULAR_SECOND_MOLAR_CARIES_EXISTENCE_AND_ASSOCIATION_WITH_PARTIALLY_ERUPTED_MANDIB
ULAR_THIRD_MOLAR&p=DevEx,5035.1
Vukelic, A., Cohen, J. A., Sullivan, A. P., & Perry, G. H. (2017). Extending Genome-wide Association Study Results to Test Classic
Anthropological Hypotheses: Human Third Molar Agenesis and the “Probable Mutation Effect”. Human Biology, 89(2), 157-169.
doi:10.13110/humanbiology.89.2.03