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NICE or not so NICE?
J Mansoor1, A Jowett, P Coulthard
1DF1, Quest Dental Care, Burnley, Lancashire, BB11 2AE.
British Dental Journal
|September 14, 2013
Summary
The National Institute for Health and Care Excellence (NICE) wisdom tooth removal guidelines lack evidence, potentially harming patient care. Patients may develop adjacent tooth decay due to delayed assessment under these guidelines.
Area of Science:
- Dentistry
- Oral Surgery
- Evidence-Based Medicine
Background:
- The National Institute for Health and Care Excellence (NICE) issued guidance on wisdom tooth removal in 2000.
- This guidance was implemented without supporting research evidence.
- Clinical decision-making in England and Wales is influenced by these guidelines.
Purpose of the Study:
- To evaluate the impact of the 2000 NICE guidance on wisdom tooth removal on patient care.
- To assess the implications of evidence-free guidelines for general dentists and oral surgeons.
- To highlight potential negative consequences for patients adhering to the current guidance.
Main Methods:
- This article presents an opinion piece.
- It reviews the lack of research underpinning the NICE guidance.
- It discusses anecdotal and emerging evidence regarding patient outcomes.
Main Results:
- The NICE wisdom tooth removal guidelines were published without a foundation in research evidence.
- General dentists and oral surgeons face pressure to comply with these guidelines.
- There is emerging evidence suggesting suboptimal patient care, including the development of caries in adjacent teeth prior to wisdom tooth assessment.
Conclusions:
- The absence of research evidence in the NICE wisdom tooth guidance may negatively impact patient care.
- Delayed or inappropriate assessment of wisdom teeth can lead to complications like caries in adjacent teeth.
- There is a need for evidence-based guidelines to ensure optimal decision-making in wisdom tooth management.
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