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Wisdom Tooth Surgery: Is It Safe?

woman having dental exam

(BlackDoctor.org) — Like any surgery, wisdom tooth extraction carries risks. The most common complication — permanent nerve damage causing numbness of the tongue, lips or cheeks — affects more than 11,000 people annually, according to a 2007 report in the American Journal of Public Health. But the surgery has also been linked to jaw and tooth fractures, brain tissue infections, life-threatening bleeding and hypoxia.

With all the risks, some dentists question whether the extraction surgeries are even necessary.

The American Association of Oral and Maxillofacial Surgeons strongly recommends that young adults have their wisdom teeth removed to “prevent future problems and to ensure optimal healing.” But the science supporting prophylactic extraction is thin.

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“Third-molar surgery is a multibillion-dollar industry that generates significant income for the dental profession,” Jay Friedman, a retired California dentist, wrote in the American Journal of Public Health. “It is driven by misinformation and myths that have been exposed before but that continue to be promulgated by the profession.”

American dentists and oral surgeons pull 10 million wisdom teeth each year — an effort that costs more than $3 billion and leads to 11 million days of post-operative discomfort, according to the report.

“At least two thirds of these extractions, associated costs, and injuries are unnecessary, constituting a silent epidemic of [physician-induced] injury that afflicts tens of thousands of people with lifelong discomfort and disability,” Friedman wrote.

Wisdom teeth are thought to have evolved for catching, killing and eating uncooked prey, which would make them obsolete now. The argument for prophylactic removal is the risk of cysts or damage to adjacent teeth brought on by too many molars in too little space.

“If left in the mouth, impacted wisdom teeth may damage neighboring teeth and nerves, or become infected, possibly inviting systemic infections and disease as the bacteria travel through the bloodstream from your mouth to other organs of your body,” reads the American Association of Oral and Maxillofacial Surgeons website.

But studies suggest no more than 12 percent of impactions lead to infections or damage to adjacent teeth — roughly the same incidence as appendicitis. No medical associations recommend prophylactic appendectomy.

Wisdom Tooth Surgery: Is It Wise?

The American Public Health Association recommended removing wisdom teeth only based on evidence of diagnosed pathology or demonstrable need, and opposes prophylactic removal, which “subjects individuals and society to unnecessary costs, avoidable morbidity and the risks of permanent injury.”

Similarly, a 1980 report by the National Institutes of Health recommended removing wisdom teeth because of infection, cavities, cysts, tumors and damage to adjacent teeth and bone. It does not recommend removing asymptomatic, fully impacted teeth.

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