Many students returned to school short of a few molars, having used the summer break to get their wisdom teeth removed. The surgery is almost like a rite of passage: It usually happens in the last year of high school or first years of college. In fact, it’s so commonplace that 10 million wisdom teeth are extracted every year nationwide. But there’s a growing debate about the need for those surgeries.
At 27, Anabel Santos is a bit older than most other patients getting their wisdom teeth removed. She got her bottom ones extracted five years ago because they were causing her pain. But this June, her dentist recommended she get her top teeth removed as well.
“I believe he had said they were going to be compacted,” Santos said. “But he didn’t really get too specific as to why it was necessary.“
In fact, the term is "impacted," and it refers to wisdom teeth that are coming in at an angle, which could cause a range of problems later on. The operation took just 30 minutes and cost her $600 — and that’s with insurance. It was a precautionary approach, but not everyone agrees that it's needed.
“One of the claims that oral surgeons make is that if you leave these teeth in place, that the chances are that they’ll cause a problem in the future,” said Jay Friedman, researcher and dental consultant in Los Angeles. “But in fact it’s less than 1 percent.”
That 1 percent refers to impacted wisdom teeth. According to his influential 2007 report for the American Journal of Public Health, when you look at all wisdom teeth, the likelihood of developing a problem is closer to 20 percent. Friedman said there may be a financial incentive because wisdom teeth extractions make up a large part of dental practice income.
“So if you were to reduce the amount of extractions, on average, they might lose as much as $500,000 a year,” Friedman said.
Louis Rafetto, president of the American Association of Oral and Maxillofacial Surgeons, disagrees.
“I can tell you that my practice, nowhere near that amount of income is generated from third molar management,” Rafetto said. Third molar is just another term for wisdom teeth.
He said it’s important to be proactive, and points to what happened in the U.K. when they recommended that healthy wisdom teeth be left in. Researchers followed patients for the next 10 years.
“At the end of the 10-year period, the number of teeth removed was as high as it was before the guidelines were put in place,” Rafetto said. “Only now patients were having their teeth out at an older age.”
And that’s a problem, because the surgery is more difficult when you’re older — the teeth are more embedded and the bone is denser. Ultimately, he said, it’s a judgment call.