The prophylactic extraction of third molars: a public health hazard

Am J Public Health. 2007 Sep;97(9):1554-9. doi: 10.2105/AJPH.2006.100271. Epub 2007 Jul 31.

Abstract

Ten million third molars (wisdom teeth) are extracted from approximately 5 million people in the United States each year at an annual cost of over $3 billion. In addition, more than 11 million patient days of "standard discomfort or disability"--pain, swelling, bruising, and malaise--result postoperatively, and more than 11000 people suffer permanent paresthesia--numbness of the lip, tongue, and cheek--as a consequence of nerve injury during the surgery. At least two thirds of these extractions, associated costs, and injuries are unnecessary, constituting a silent epidemic of iatrogenic injury that afflicts tens of thousands of people with lifelong discomfort and disability. Avoidance of prophylactic extraction of third molars can prevent this public health hazard.

MeSH terms

  • Adolescent
  • Adult
  • Dental Prophylaxis / adverse effects
  • Dental Prophylaxis / ethics
  • Dental Prophylaxis / statistics & numerical data
  • Facial Nerve Injuries / epidemiology*
  • Facial Nerve Injuries / etiology
  • Humans
  • Iatrogenic Disease / epidemiology*
  • Incidence
  • Molar, Third / pathology
  • Molar, Third / surgery*
  • Paresthesia / epidemiology*
  • Paresthesia / etiology
  • Pericoronitis / epidemiology
  • Pericoronitis / prevention & control
  • Practice Guidelines as Topic
  • Prevalence
  • Public Health
  • Risk Assessment
  • Societies, Dental / standards
  • Surgery, Oral / economics
  • Surgery, Oral / ethics
  • Surgery, Oral / standards
  • Tooth Extraction / adverse effects*
  • Tooth Extraction / economics
  • Tooth Extraction / statistics & numerical data*
  • Tooth, Impacted / pathology
  • Tooth, Impacted / surgery
  • United Kingdom
  • United States / epidemiology
  • Unnecessary Procedures / adverse effects*
  • Unnecessary Procedures / economics
  • Unnecessary Procedures / statistics & numerical data