Etiology and indications for the management of impacted teeth.

Impacted teeth are a medical deformity brought about by the dietary changes of modern civilization. Ample studies exist to show that the lack of a coarse, abrasive diet--an attritive diet--is the major cause of this problem in modern civilization. Our recent ancestors did not experience this problem or the problem of the underdeveloped lower jaw and resulting Class II malocclusion to the extent present in modern society. Medical and dental scientists, practitioners, and surgeons are aware of the devastation that impacted teeth can cause to the jaws and overall health of an individual and have issued numerous warnings to the profession and to the public regarding the several clear indications for the removal of impacted teeth. The issue has been clouded by the competing economic incentives present in our society, in which fee-for-service practitioners have been and are being replaced by practitioners with a disincentive to recommend surgical care for all but acutely infected or seriously symptomatic patients presenting with impacted teeth. Oral and maxillofacial surgeons practicing in the United States at this time are aware of the many clear indications for removal of impacted teeth and make every effort to communicate this information to their patients and other dental and medical practitioners. They are also aware of the contraindications to the removal of impacted teeth and advised patients appropriately when it is safe to retain and periodically observe by radiograph certain impacted teeth.