INTRAOBSERVER RELIABILITY REGARDING REMOVAL OF ASYMPTOMATIC 3RD MOLARS

Objective To investigate reliability of practitioners' removal decisio ns and judgements of risk of pathology associated with asymptomatic th ird molars. Subjects 10 oral surgeons and 18 family dentists from Sout h Wales with experience ranging from 5 to 28 years. Method Participant s were presented with periapical radiographs of 36 asymptomatic, mandi bular third molars and were informed of the age and sex of the patient s and the degree of eruption of the third molars. Participants were as ked to assess, using visual analogue scales, the likelihood of future pathology if the third molars were left in situ and to indicate if the y should be removed or not. To assess intra-observer reliability, the 36 cases were duplicated and presented to the participants on a differ ent occasion, a month later. The same questions were asked as on the f irst occasion. Results Significant correlations (Pearsons correlation coefficients) were found between initial and repeat assessments of all measures but there was little agreement about the need for removal (K appa values: 0.54 for oral surgeons and 0.41 for the family dentists). For every item studied, changes in position on the visual analogue sc ale of two-thirds or more of the total length occurred from the first to the second assessment. Conclusion Treatment decisions about whether or not to remove asymptomatic third molars were not made on a rationa l basis. Since similar conclusions were recorded in a previous Swedish study, it is inferred that until further high quality evidence of dis ease prediction is published, decisions to remove third molars prophyl actically cannot be made reliably.