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AJPH First Look, published online ahead of print Jul 31, 2007
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September 2007, Vol 97, No. 9 | American Journal of Public Health 1554-1559
© 2007 American Public Health Association
DOI: 10.2105/AJPH.2006.100271

HEALTH POLICY AND ETHICS

The Prophylactic Extraction of Third Molars: A Public Health Hazard

Jay W. Friedman, DDS, MPH

Jay W. Friedman is a retired general dentist and a consultant and writer living in Los Angeles, Calif.

Correspondence: Requests for reprints should be sent to Jay W. Friedman, 3057 Queensbury Dr, Los Angeles, CA 90064 (e-mail: drjfriedman{at}sbcglobal.net).

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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