longterm evaluation of estimates of need for third molar removal purpose the aim of this study was to evaluate the estimates on need for third molar removals made at age 20 after 12 yearspatients and methods the series consisted of 81 university students followed from age 20 to 32 years at baseline and at study end these students were clinically examined and panoramic radiographs were taken at baseline in 1982 a qualified oral surgeon had made estimates on need for removal of third molars within 5 years 75 of students needed removals actual treatment performed was evaluated after 12 years a questionnaire served to determine symptoms related to third molars during the 12year periodresults during the followup one or more third molars had been removed from 67 of the former students a total of 155 third molar removals had been estimated but by age 32 years the percentage actually removed was only 59 of the 79 third molars taken out at the finnish student health service 77 were initially estimated to need a surgical procedure but actually 66 were simply extracted most were removed at around age 27 years according to the questionnaire 67 of the students were asymptomatic in the third molar region during 12 yearsconclusion because need for surgical removal decreases during early adulthood routine prophylactic extraction of asymptomatic third molars in young adults cannot be recommended welldefined indications for prophylactic removals are needed