Potentially Preventable Hospitalisation Related to Severe Third Molar Disease: A Systematic Review

Background/Objectives: One of the most common oral surgery procedures performed in dentistry is the removal of third molar teeth (3M). Complications of both retention and removal of third molars are associated with potentially preventable hospitalisations (PPH). This study aims to systematically review the published literature to identify demographics, aetiology, incidence, associated factors, length of hospital stay (LOS) and variables influencing the outcomes of PPH arising from 3M. Methods: An electronic literature search was performed using Medline and Embase via Ovid in May 2024, and relevant studies were analysed for demographics, aetiology, incidence, related factors and LOS associated with PPH resulting from 3M. Results: Nineteen publications with sample sizes ranging from 37 to 3549 patients per study were identified. Two studies reported 101 patients described PPH specifically related to 3M. The remaining 17 studies described 6153 oral health-related PPH, predominantly arising from broader odontogenic infection cohorts, of which 1654 (26.9%) PPH were associated with 3M. The mandibular 3M was implicated in 98.5% of 3M-related PPH. Pericoronitis and postoperative infections following 3M removal were reported as the leading causes of hospitalisation, whereas data on dental caries were not reported. Similarly, most studies did not report detailed information on demographics, aetiology, or outcomes specific to third molars. Conclusions: Available indirect data shows that 3M-related dental infections, including post operative infections, contribute to oral health-related PPH. There are significant evidence gaps in third molar-specific PPH data. Further studies with standardised reporting focusing on third molar-related hospitalisations are required to identify factors influencing clinical outcomes and to inform evidence-based clinical decision-making regarding the removal or retention of third molars.