UNC-CH School of Dentistry receives $2 million for wisdom teeth clinical trial

CHAPEL HILL -- The fear of possible infection and pain prompts many people to have their wisdom teeth removed in their late teens.

A new clinical study led by Dr. Raymond P. White, Dalton L. McMichael professor of oral maxillofacial surgery at the UNC-CH School of Dentistry and the school's former dean, will study how to predict which patients are at high risk for wisdom teeth infection, and other quality-of-life issues.

The "Third Molar Clinical Trials" study is supported by a $2-million grant from the Oral and Maxillofacial Surgery Foundation and the American Association of Oral and Maxillofacial Surgeons. During the first phase of the study, UNC-CH researchers will work with researchers at the University of Kentucky School of Dentistry.

More than 95 percent of people are born with at least one wisdom tooth, and today, most teen-agers have them removed to prevent potential problems. The recommended time for removing wisdom teeth is during the late teens.

"Teens heal faster, 3-5 days, while adults take 7-10 days or longer," said White.

White said the location of the wisdom tooth -- which dentists call the third molar -- makes it difficult to clean, causing infection and gum disease with eventual bone loss around adjacent teeth. The patient often has no symptoms until infection is advanced. By the time the patient notices pain and swelling, there already is bone loss.

"The infection can be cleared up by taking antibiotics, but if the teeth are not cleaned properly, bacteria will increase in numbers and infection will occur again," he said.

Problems with wisdom teeth are more prevalent now, White said. In the past, people often lost teeth, leaving room in their mouths for wisdom teeth. Today, better access to dental care and fluoride means people are losing fewer teeth and, therefore, have less room for wisdom teeth.

If they can be cleaned easily and help chew food, third molars often can remain. Patients who keep them need to be followed by their dentist and have regular x-rays and cleanings, said White.

Unique to this study, researchers will consider non-clinical outcomes, such as the patient's perception of the procedure. For example, the dentist might tell a patient the jaw is healed, but if the patient has problems chewing and resuming usual activities, that will affect his or her perception of the procedure's success. By gathering data such as this, researchers hope to give dentists and patients better information about the experience, thus allowing patients to choose whether to keep or remove their wisdom teeth.

The first phase of the study will involve 500 people aged 14 - 45 who have four wisdom teeth. Participants will retain their teeth during the five-year study unless a change in their oral health necessitates removal. Data collection will include X-rays to monitor bone loss, plaque samples to identify bacteria and gingival fluid samples to quantify cytokines, which reflect the patients' immune response to changes around the wisdom teeth.

People interested in participating in the study should call Charlotte Stokley, clinical coordinator, at the UNC-CH School of Dentistry, at 919-966-8376.

Dental School contact: Alice Lockhart, 919-966-4563
News Services contact: Karen Stinneford, 919-962-8415

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