Background and objectives: Third molar surgery (TMS) is commonly performed in the NHS. In 2000 the National Institute for Health and Clinical Excellence (NICE) introduced guidelines for TMS, outlining specific indications and recommending against prophylactic surgery. This retrospective observational study aims to evaluate the changes in patient demographics undergoing TMS between 1994 and 2012 at Northampton General Hospital.

Methods: The codes F091 (Surgical Removal of Impacted Wisdom Tooth) and F093 (Surgical Removal of Wisdom Tooth NEC) were used to obtain data from the Northampton General Hospital Episodes Statistics Database.

Results: Between 1994 and 2012, 10,447 patients were treated in 10,998 treatment episodes. More female patients were treated with a statistical significance of p = 0.0004. The mean patient age increased from 29 in 1994 to 36 in 2012, with the median also increasing from 27 to 31 years ( p < 0.001).

Conclusions: Older patients undergoing TMS are more likely to experience complications including neurosensory deficit and mandibular fractures. The authors’ findings would imply that the NICE guidelines require review. Certainly consideration should be given to the removal of a similarly impacted, asymptomatic, contra-lateral third molar without obvious radiographic relationship to the inferior dental canal, if a young patient is undergoing general anaesthesia.

Key words: NICE; third molars; age