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Wisdom Teeth

There are three sets of molars in each corner of the mouth. Wisdom teeth form the third molar in each corner of the mouth. They do not usually develop until the teens or early twenties. When they do, it can cause problems due to pressure on adjacent teeth and overcrowding.

For decades, wisdom-tooth removal has been performed only when the wisdom teeth start to cause real trouble, like in the case of appendectomies. After World War II, however, the ranks of dentists exploded, and with them recommendations that people get their third molars removed as a precaution. As dental care got more advanced—and the financial incentive to perform the procedures increased—wisdom teeth removal began to become as routine as getting braces.

Today, many still undergo this procedure for legitimate reasons in our dental clinic: as ingrown or impacted wisdom teeth can lead to infections, tooth decay, and generally unpleasant levels of pain.

But a large percentage of patients from the UK contact us to have their wisdom teeth removed merely as a precaution, and I estimate that at least two-thirds of the cases that contact us should have their wisdom teeth left in.

A 2002 paper published in the Journal of the Canadian Dental Association estimated that the complication rate from wisdom teeth surgery was between 7% and 10%. A 2011 study of more than 6,000 patients in Greece found that only 2.7% of in-tact wisdom teeth result in problems. And an older study often cited by critics of routine extraction found that only 12% of surveyed middle-aged patients experienced a complication from keeping impacted wisdom teeth.

Indeed, Britain’s National Health Service now advises the following on wisdom teeth removal:

Your wisdom teeth don’t usually need to be removed if they’re impacted but aren’t causing any problems. This is because there’s no proven benefit of doing this and it carries the risk of complications.

Even if they’re impacted!

Another study published in 2006 by the Cardiff University in Wales found a slightly higher incidence of teeth eventually having to be removed, but also concluded that there was “little support for the reintroduction of prophylactic removal of wisdom teeth,” referring to the already declining practice in the region.

In a 2011 New York Times story on this debate, health writer Roni Caryn Rabin said that the price of leaving your teeth in was that you’ll have to be extra fastidious about your own dental care, with frequent cleanings and X-rays if necessary.

If that’s the price to pay for avoiding major surgery, it seems like a bargain.

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