All impacted teeth should be removed unless specific contraindications justify leaving them in position. When the potential benefits outweight the potential complications and risks, the procedure should be performed. Similarly, when the risks are greater than the potential benefits, the procedure should be deferred. Contraindications for the removal impacted teeth primarily involve the patient's physical status.
Extremes of age
The third molar tooth bud can be seen radiographically by age 6. Some surgeons think that removal of the tooth bud at age 7 to 9 can be accomplished with minimal surgical morbidity and therefore shoud be performed at this age. However, most surgeons believe that it is not possible to predict accurately if the forming third molar will be impacted. The consensus is that very early removal of third molars should be deferred until an accurate diagnosis of impaction can be made.
The most common contraindication for the removal of impacted teeth is advanced age. As a patient ages, the bone becomes highly calcified and therefore less flexible and less likely to bend under the forces of tooth extraction. The result is that more bone must be surgically removed to displace the tooth from its socket.
