The effect of age on third molar extraction difficulty: a retrospective cross-sectional cohort study

This study aimed to clarify whether third molar extraction becomes more difficult as the patient ages. Previous research results on the topic are contradictory.

All 12,649 third molar extractions in Helsinki's primary care during 2016 were retrieved from electronic records using treatment codes. The primary outcome was extraction difficulty, classified as simple (forceps) or surgical (raising a flap). The secondary outcome was an extraction labelled as demanding. Predictor variables were age, sex, and the jaw (maxilla/mandible). Statistical analyses included χ2 test and binomial logistic regression.

Mean age of the patients was 32.2 years (range 12-97 years). Simple extractions in the maxilla (P < 0.001) and all surgical extractions (P < 0.001) were more likely to be demanding at a higher age. In the mandible, simple extractions were easier at a higher age (odds ratio [OR] 0.971; 95% confidence interval [CI] 0.964; 0.978). Surgical extraction was 1.4 times (95% CI 1.145; 1.766) more likely to be demanding in men and twice (95% CI 1.143; 3.462) as demanding in the mandible.

Surgical and maxillary simple extractions were more difficult at a higher age. Surprisingly, in the mandible, simple extractions were easier at a higher age.