The microbiome of the distal aspect of the second molars
Research type
Research Study
Full title
The assessment of the microbiome on the distal aspect of the second mandibular molar adjacent to a variety of differently angulated impacted third molars.
IRAS ID
227843
Contact name
Verena Toedtling
Contact email
Sponsor organisation
The University of Manchester
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Summary of Research
Dental plaque is an organised biofilm which is composed of unique microbial communities (microbiome) on various tooth surfaces. The microbiome can be distinctly different on sites accessibly to a toothbrush. In addition to this, dominant species from healthy sites are different from those found in diseased sites with Streptococcus and Lactobacillus spp. are known to be implicated in dental decay.
Long-term retention of angulated wisdom teeth (third molars) has been associated with plaque retention and development of decay (caries) in the second molar, the tooth immediately adjacent to the wisdom tooth. This decay type with reference to a third molar is also known as distal surface caries (DSC).
In the last decade several studies have focused on the increase in DSC and our systematic review showed that DSC is on the rise globally. European based studies suggest that at least 1 in every 5 patients referred to a hospital setting for a wisdom tooth assessment is affected by DSC. Interestingly, second molars next to third molar with a forward facing angulation form a plaque stagnation area and are at significantly greater risk to DSC in comparison to any other wisdom tooth angulation.
Unfortunately, at present the wisdom tooth guidance issued by NICE (National Institute for Health and Care Excellence) do not recognise this decay type as a problem and strictly recommend against prophylactic removal of third molars. However, the latest research suggests that the vast majority of patients ultimately require removal of the third molar as pathology such as DSC develop in later life.
The proposed project is aimed to find whether there are differences in the proportion of decay causing bacteria on the distal surface on the second molar. An assessment of the microbiome will greatly increase our understanding of the aetiology of DSC.
Summary of Results
Long term retention of impacted third molars (wisdom teeth) is associated with plaque stagnation and development of caries on the distal surfaces of the neighbouring mandibular second molar. Whilst caries and tooth loss are common outcomes of impaction, there is not currently enough evidence to advise for pre-emptive removal of asymptomatic wisdom teeth. Emerging evidence suggests that wisdom teeth impactions are more associated with caries. Therefore, we have investigated the oral composition of dental plaque on the distal-surface of the mandibular second molar at four angulations, and where the wisdom tooth is missing
REC name
East Midlands - Leicester South Research Ethics Committee
REC reference
17/EM/0340
Date of REC Opinion
22 Aug 2017
REC opinion
Favourable Opinion