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

The prophylactic extraction of third molars: a public health hazard

Jay W Friedman  1
Affiliations

The prophylactic extraction of third molars: a public health hazard

Jay W Friedman. Am J Public Health. 2007 Sep.

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.

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Figures

FIGURE 1—
FIGURE 1—
A mesioangular impaction, with the roots in close proximity to or saddling the mandibular canal containing the mandibular nerve.
FIGURE 2—
FIGURE 2—
Panographic radiograph of 4 normally developing wisdom teeth, classified as full bony impactions at the time of extraction.
See this image and copyright information in PMC

Comment in

  • Mythbusters and wisdom teeth.
    Dodson TB. Dodson TB. Am J Public Health. 2008 Apr;98(4):581-2; author reply 582. doi: 10.2105/AJPH.2007.129577. Epub 2008 Feb 28. Am J Public Health. 2008. PMID: 18309118 Free PMC article. No abstract available.
  • Long-term outcome of retained third molars is unknown.
    Pollan LD, Pogrel MA. Pollan LD, et al. Am J Public Health. 2008 Apr;98(4):580-1; author reply 582. doi: 10.2105/AJPH.2007.129247. Epub 2008 Feb 28. Am J Public Health. 2008. PMID: 18309120 Free PMC article. No abstract available.

References

    1. Statements by the American Association of Oral and Maxillofacial Surgeons Concerning the Management of Selected Clinical Conditions and Associated Clinical Procedures: The Management of Impacted Third Molar Teeth. Rosemont, Ill: American Association of Oral and Maxillofacial Surgeons; 2007.
    1. American Dental Association. 1999 survey of dental services rendered [unpublished report]. ADA Catalog No. SDSR-1999.
    1. Stanley HR, Alattar M, Collett WK, Stringfellow HR, Spiegel EH. Pathological sequelae of “neglected” impacted third molars. J Oral Pathol. 1988;17:113–117. - PubMed
    1. Leonard MS. Removing third molars: a review for the general practitioner. J Am Dent Assoc. 1992; 123:77–92. - PubMed
    1. Hold on to your wisdom teeth. Consum Rep Health. 1993;5(8):84–85.

MeSH terms

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