The prophylactic extraction of third molars: A public health hazard

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.