Most Wisdom Tooth Extraction Totally Unnecessary

by Sarah Oral HealthComments: 467

wisdom tooth extractionOver Spring Break during my senior year in college, I endured wisdom tooth extraction like just about everyone else I knew my age.  Needless to say, I spent most of  my vacation on the living room couch with my mouth loaded with gauze!

Prior to surgery, were my wisdom teeth infected or painful in any way?

No.

Were they causing any sort of problems for me whatsoever?

No.

Then why in the world did I have them out you might ask?

Good question!

As it turns out, over two-thirds of cases of wisdom tooth extraction are completely unnecessary says Dr. Jay Friedman DDS in a study published in the American Journal of Public Health.

Of the approximately 5 million people who endure wisdom tooth extraction each year, 11,000 suffer what’s called “permanent paresthesia” which is a fancy name for numbness of the lip, tongue, and cheek resulting from nerve damage during the surgery.

The problem is, wisdom tooth extraction is quite the little oil well of profit for dentists with the costs of such surgeries topping 3 billion US$ each and every year.

Sounds like the standard practice of wisdom tooth extraction is a bit like “finding and filling” cavities that don’t exist, doesn’t it?

Ah, yes.  There’s the rub.

According to Dr. Friedman:

Third-molar surgery is a multibillion-dollar industry that generates significant income for the dental profession, particularly oral and maxillofacial surgeons. It is driven by misinformation and myths that have been exposed before but that continue to be promulgated by the profession.

Dr. Friedman goes on to dismantle in very compelling fashion the 5 myths of wisdom tooth extraction.

Myth #1:  Most Wisdom Teeth Cause Problems

The truth is that only 12% of wisdom teeth actually cause an acute issue somewhere down the road that requires the attention of a dentist to resolve.  This is about the same rate as appendicitis, but people do not routinely and preventively have their appendix removed like what happens with wisdom teeth!

Myth #2: Early Wisdom Tooth Extraction is Less Traumatic

The American Association of Oral and Maxillofacial Surgeons recommends extraction of all 4 wisdom teeth by early adulthood before the roots are fully formed to minimize any chance of infection and pain.

The truth is that this early removal of wisdom teeth is actually much more traumatic than a wait and see approach which leaves asymptomatic wisdom teeth in place and only removes them if pathology develops in the future.

Further, complications from wisdom tooth extraction which include dry socket, secondary infection, and paresthesia (numbness of the lip, tongue and cheek) are less likely to occur in an older patient than an adolescent.

Myth #3:  Erupting Wisdom Teeth Crowd Anterior Teeth

Dr. Friedman writes that it is simply not possible for wisdom teeth to crowd 14 other teeth with firm vertical roots.  There is simply not enough force to do so and multiple studies support this fact.

Myth #4: The Risk of Problems with Wisdom Teeth Increases With Age

A study of 1756 people who kept their wisdom teeth for an average of 27 years found that less than 1% experienced any cyst formation.   There is zero evidence to support the unsubstantiated claim by the American Association of Oral and Maxillofacial Surgeons which states that problems with impacted wisdom teeth increase with age.

Myth #5: The Risk of Harm in Wisdom Tooth Extraction is Small

The list of potential complications from wisdom tooth extraction is long:

Pain
Swelling
Trismus (lockjaw)
Hemorrhage
Alveolar osteitis (dry socket)
Periodontal damage
Soft-tissue infection
Injury to temporomandibular joint
Malaise
Temporary paresthesia (numbness of the lips, tongue, and cheek)
Permanent paresthesia
Fracture of adjacent teeth
Fracture of the mandible
Fracture of the maxilla
Sinus exposure or infection
Anesthetic complications

Even in cases where there are absolutely no complications whatsoever, wisdom tooth extraction requires 3 days of discomfort and disability while the patient recovers from surgery.

Given that no more than 12% of wisdom teeth ever cause any problems whatsoever at any point down the road, the risk of removal seems great in comparison.

Skip That Surgery!

So, if your dentist tells you or your child that it’s time for those wisdom teeth to come out when they aren’t causing any trouble at all, just politely smile, say “uh, no thanks”, and go home.

You just saved yourself a rather large chunk of change my friend.

Cha-Ching!

Sarah, The Healthy Home Economist

Source:  American Journal of Public Health, The Prophylactic Extraction of Third Molars: A Public Health Hazard, Jay Friedman DDS

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