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Hold on to Your Wisdom Teeth

Getting your wisdom teeth removed has become a rite of passage, particularly in the United States and Australia. Many dentists routinely recommend removal of the teeth. If they are impacted – in other words, still below the gum line – this can involve surgery and all that entails: general anesthetic, stitches, and a week or more of recovery.

More and more, however, experts are questioning the necessity of these surgeries. There is a growing body of research that indicates removal of wisdom teeth may be completely unnecessary. Certainly, if there is infection, damage to neighboring teeth, cysts, or intractable pain, extraction may be the best treatment. It is the other types of cases that are causing concern.

Routine removal of third molars (the actual name for wisdom teeth) was abandoned in 1998 in the UK, following a study by the University of York that determined there was not scientific evidence to support the practice. The same year, the Royal College of Physicians of Edinburgh also concluded that routine removal is “not advisable”.

Conversely, the logic in countries that still practice routine extraction is that leaving in the wisdom teeth will simply delay the inevitable infection or complications that will appear later on. Following that reasoning, 10 million wisdom teeth were removed in the United States in 2011.

Still, in many countries, including the US and Australia, routine wisdom teeth removal remains the standard procedure. The reason given is that leaving them in is simply putting off the inevitable, because patients with wisdom teeth will face infection or complications later on.

Based on that logic, in 2011, 10 million wisdom teeth were removed from Americans’ mouths, and in 2015 in Australia, seven times as many people were hospitalized for the removal of impacted wisdom teeth as in the United Kingdom.

In 2014, researchers reviewed seven papers to examine the result of allowing young people to retain their wisdom teeth. Fusion reported on the study:

The review concluded that the risk of having to undergo removal appeared to increase as subjects aged, but at least one of the studies in the [review] concluded no such thing. Rather, the British study found that 83.13 percent of patients survived the one-year study period symptom-free, and just 5 percent had to have teeth removed.

A report in the New York Times stated:

There does not appear to be a single randomized clinical trial – the gold standard for scientific proof – comparing similar patients who have and have not undergone prophylactic wisdom teeth removal.

Instead, there is a growing body of research that suggests much of the wisdom tooth removal is unnecessary. A Greek 2011 study of over 6,000 patients who had had wisdom teeth removed found that only 2.8 percent of the teeth had a tumor or cyst. An older study from 1988 demonstrated that just 12 percent of 1,756 middle-aged people who retained their wisdom teeth had experienced a complication.

In the New York Times article, University of Washington chairman of orthodontics commented:

Everybody is at risk for appendicitis, but do you take out everyone’s appendix? I’m not against removing wisdom teeth, but you should do an assessment and have a good clinical reason.

At the very least, suggest experts, get two or three opinions before proceeding with wisdom teeth removal.