My wife is a dentist. She told me that you really should have your wisdom teeth removed in two general instances:<p>* The teeth are growing in a strange orientation.<p>* You have cavities on them and your jaw shape is such that you can't brush them properly.<p>---<p>The major problem with the molars is that they are notoriously difficult to keep clean. They all eventually become abscessed (on a long enough timeline). Might as well remove them. So removing wisdom teeth is not really a scam, it's something you will need sooner or later unless you're really anal about keeping your wisdom teeth clean. Can you brush all the way back there? How about behind the wisdom tooth?<p>I have also noticed a trend here in the US that dentists put you under general anesthetic for this procedure. When in reality, unless you -really- need surgery, it's just overkill. For example, when I had my wisdom teeth removed in Bolivia, I was entirely awake, they only used local lidocaine (or similar) using a syringe, and they pull them out using hand tools and levers. Some antibiotics for a couple of days, and I was on my way.
Just one data point, but: as a teenager I was told "your wisdom teeth might end up being fine, but most people end up having to get them pulled; it's up to you." I passed.<p>Fast-forward a decade or so, one of them was, to use the technical term, totally fucked. It was impacted, uncleanable in parts and thus had to be removed, but had gotten so wedged in that it not only pushed my other teeth crooked, but was extremely hard to extract, requiring the dentist to go fetch some other stronger dentist and then they both worked on it and it took way longer than planned to get all the pieces out.<p>That was lame, but I still have the other three, and now my dentist says the same thing is happening to those (and even I can tell, it is).<p>So now I am 41 with a busy job and young children, and I have to find time to have three wisdom teeth extracted in a procedure that is now going to be much more difficult than the simple extraction suggested by my dentist 20 years ago.<p>So, in my case, I wish I did it then.
All of the RCTs conclude that there is no evidence that removing unsymptomatic wisdom teeth is beneficial:<p><a href="http://bestpractice.bmj.com/best-practice/evidence/intervention/1302/0/sr-1302-i1.html" rel="nofollow">http://bestpractice.bmj.com/best-practice/evidence/intervent...</a><p>Given the major surgery involved, it seems best avoided. I have had two impacted wisdom teeth for over 20 years with no problems (using good dental hygiene).
When I was 21, my dentist wanted to remove my wisdom teeth. I asked him why, he said "because wisdom teeth are difficult to clean and you'll likely lose them by age 30 anyway because of that." I replied that since they were healthy now, I'd wait and see, and got a new dentist.<p>I'm 56 now and my wisdom teeth are still there and still healthy.
My grandfather started practicing dentistry in the '20s and my mother in the '50s, so my thoughts come from them (paraphrasing):<p>While many people may not have an urgent need to get rid of their wisdom teeth at age 18 (or even 50), it is a very simple extraction before these teeth have taken root. After they have rooted, it is more complicated, and more painful. These teeth are unnecessary, and one can eat perfectly fine without them. The most horrible stories I heard as a kid were mostly about wisdom teeth causing crowding and/or gum issues. To each their own, of course, but I believe the prudent route is to have them removed when you are 18 (or whenever they start to come in for you).
What Rob (the author) went through is hard, and left him understandably butthurt about oral operations. Maybe he's one of the people who didn't need the operation but had it done, and there were complications. If he posted his taken-then x-rays online today, maybe other dental professionals could weigh in on whether it was a good idea at the time?<p>What this article doesn't emphasize enough is:<p>1) Like fingerprints, teeth are unique from person to person.<p>2) There are legitimate medical reasons to remove wisdom teeth, and those reasons vary from person to person.<p>Like a cartoon, I have a small mouth with big teeth. Thus, like San Francisco, I've had "space scarcity" for the better part of 2 decades.<p>My dental journey took over a decade of planning and execution, as well as 10s of thousands of dollars so I'd have some kind of decent smile as an adult. (thanks Mom and Dad!)<p>Had I "passed" on this work, I wouldn't have anything close to resembling a smile today - a high price to pay.<p>Maybe Rob's family should have consulted second more dentists/oral surgeons. Maybe they didn't have the resources.<p>Technology will likely help us make better decisions about these procedures in the future so "unnecessary" treatment spending goes down.
The basic point - that many people have their wisdom teeth removed unnecessarily - might be valid, but the author does a poor job proving it. Cherry-picking one study that followed <i>young adults</i> for <i>only one year</i> doesn't address the issue of orthodontic and periodontal problems that take decades to manifest fully - a pretty obvious point that remains unaddressed through the remainder of the article.<p>When I see such blatant intellectual malfeasance, I just stop reading. If it's really a valid point, someone else will make it without distorting or misrepresenting the truth. If it's not - which is what usually turns out to be the case - I will have saved time and energy. Life's too short to waste it on polemicists.
I used to get lots of headaches from 15-25, maybe 3 a week. I learned to live with it. At 25 I had my wisdom teeth removed for the regular reasons, and noticed that I got a lot less headaches in the next few weeks. I now get maybe 2 headaches a month. I've never heard of this from anyone except myself, and doctors just go "hmm. intereseting." -- just wanted to share this.
Get em' removed when if (when) they become a problem.
I still have mine. My Dad got his removed when he was 50-something. He says that it's a lost easier to clean behind the teeth, and that he used to have gum growth over the wisdom teeth before along with bleeding as a result, which is no longer a problem.
My wisdom teeth pointed pretty much straight forward, so removing them was pretty much mandatory. I don't appreciate the title. This is one of the first times I've seen that the actual article has a less editorial title.
Throughout my life, dentists have wanted my wisdom teeth. I've opted to keep them. At my last checkup, my dentist told me that he had changed his opinion, and no longer takes them out if they're healthy.
The article claims "intensive" and "major" surgery. I had local anesthesia and 15 minutes in the dental surgeon's chair. Is it done differently in the U.S.?
The "10M teeth/yr" statistic, assuming it's even accurate, doesn't seem like that much to me. Most people have four wisdom teeth. That seems to imply that less than half the people in USA have gotten this procedure. (It also makes one wonder why TFA didn't work a little harder to get current/relevant/accurate statistics.)<p>It's true that many people who have had their wisdom teeth pulled didn't need that. It's also the case that many people who didn't have them pulled while they were young, have lived to regret that.<p>Most dentists would be happy to never pull another wisdom tooth. However, they've taken an oath to provide a standard of care, and they can't refer every wisdom tooth case to expensive oral surgeons. (Well, I think some dentists do refer every one of these out, but that's a threat to patient retention.)<p>USA simultaneously has too many and not enough dentists. Too many, because there are lots of unnecessary procedures done. Not enough, because many poor people don't go to the dentist until they're in severe pain, and at that point they need many teeth pulled. Those who live long enough eventually need all their teeth pulled anyway...
Another angle to consider... My oral surgeon said the nerves in your face migrate around as you age. Later in life, one of those nerves is closer to the wisdom teeth, so the chance of nerve damage during extraction is higher. Edit: I did local anesthesia in the USA. They shot everything up, let it take effect, and then yanked them out. I'll never forget that sound...
I remember when my wisdom teeth started causing me problems in my early 20s.<p>The lower ones caused some kind of infection that wasn't treatable and my gums started leaking a terrible puss that was pretty disgusting to be frank about it. Perhaps it would have all sorted itself out in a few months. But throwing up 4 or 5 times a day was making it hard to get nutrients so I went in, got knocked out, and them hacked out of my head.<p>The were so impacted the dentist had to break part of my jaw and I was unable to open my mouth for about 8 weeks while it healed and it was months before I could fully open my mouth again.<p>But guess what? No puss, no more barfing and I haven't had any problems since. So I think that was probably the right choice and if I had to do it over again I would have had them carved out of my skull 5 years earlier before they had become a painful and disgusting problem.
I'd be interested in seeing studies done on recovery times from dental procedures pitting local vs. general anesthesia. If you're awake, it seems more likely that the dentist will practice extra caution, so it seems logical that recovery times for procedures done under local should be better.
In the UK my dentist said its up to me. They don't recommend it any more but are happy to do it if you want.<p>Mine do catch a fair bit of food and get minor infections relatively frequently (maybe every three months they hurt for a few days). I want them out but don't want to go through the process.
Mine were horizontal and were going to be a problem. The surgery was a breeze and almost painless afterwards. Going through the constant ache of braces for a few years is far worse.
My dad who's a year or two short of 70 has wisdom teeth that never "erupted". Personally mine did at the age of ~20, but my orthodontist at the time thought they needed to be removed a couple of years before because they were pointing the wrong way. My dentist thought otherwise and I took his advice.<p>I'm half convinced that the whole "wisdom teeth industry" is just a great way to legally get some opioid painkillers.
Last visit to dentist ,he mentions his parents are both doctors. I asked , why didn't you go into medicine. He told me his parents urged him into dentistry. They felt their professions had changed ( negatively ) so much from their early careers. He said mostly due to pharma taking over and they no longer had any autonomy. They knew he would have more freedom and autonomy as a dentist.
I had a dentist tell me I should get my wisdom teeth pulled within the next year.<p>Next year, same place, different dentist at my regular cleaning. He gave me a clean bill of health. I asked him, "What about my wisdom teeth?"<p>He said "What about them? Are the bothering you?"<p>"Well, no..."<p>"Then you're fine." And he left.
There is a lot of variation in people's mouths.<p>My teeth are really big and I was really bad about wearing a retainer. If I didn't have 4 teeth removed, my bottom set would have become more crooked than my baby teeth were if I let my wisdom teeth come in.
I'm almost 40 and have not had my wisdom teeth out. I can tell you they hurt from time to time; and they have caused other molars to crumble as a result.<p>It's not really a scam; the way the wisdom teeth roots grow in make it very hard to remove.
My thoughts exactly. I'm in my 30's, I've never had dental problems and every time I go to a dentist and he suggests to remove my wisdom teeth, I change to another dentist.<p>These teeth exist for a reason, and mine - luckily - were developed in a perfectly straight way in line with the rest of my teeth. Suggesting to remove them seems just ridiculous to me and a greedy way for the dentist to make some hundreds of euros extra by butchering me off.
I'm 29 years old and have six wisdom teeth at the moment.<p>I have two protruding out of the upper jaw which haven't caused me any problems, so the (UK NHS) dentist said they don't need to come out. X-rays showed that there was actually another unemerged tooth behind each of them as well. These upper teeth have all been there for for about 7 or 8 years now and haven't caused me any discomofort beyond the initial breaking of the gum.<p>On the lower jaw however, both teeth are impacted. The left wisdom tooth is completely horizontal and pushing up against the molar in front and the lower right wisdom tooth is impacted at an angle and irritates the gum around it from time to time. I usually pop some ibuprofen when it gets uncomfortable.<p>I've wouldn't say I've experienced serious pain from these teeth, more just a dull ache or discomfort or irritation of the gum, but I was referred to a dental surgeon a year or so ago who basically told me he wouldn't take them out.<p>He claimed that the lower teeth were so well developed at this point that removing them might expose the nerve in my jaw underneath and leave the lower half of my face numb, potentially for the rest of my life. As a risk/benefit calculation he decided against taking them out for now, but may change his mind if they cause problems in the future, which they likely will.<p>This is an NHS dental surgeon though and I'm wondering if I might be best served getting an a second opinion from a private dentist as well. The last few days my lower right tooth has been really irritating the gum around it that I've been taking ibuprofen for two or three days.<p>If I went to the dentist when these originally started to emerge instead of waiting until they started to cause some discomfort I could have had them removed with much less risk. I was however under the assumption that wisdom teeth should only be removed when they cause problems, which for the first few years mine didn't really.
If you're having your wisdom teeth out like most surgery it's prudent to get a second opinion. Also I'd strongly advise local anesthesia. IMO general anesthesia should be avoided whenever possible. I'm not a medical person but I've seen too many people who had bad side effects from general anesthesia and some who were never the same again.