Last year, my daughter, along with about 5 million other Americans had her wisdom teeth pulled. Why? We were told by her dentist that her wisdom teeth were crowding out her other teeth. If we didn’t remove the offending wisdom teeth, infection and even jaw growth damage could occur.

It turns out that despite recommendations of  the American Association of Oral and Maxillofacial Surgeons, there is very little hard evidence that failure to remove wisdom teeth represents a major health hazard. About 12% of wisdom teeth will eventually lead to an infection. Guess what? That’s about the same percentage of infections that occur from the appendix. Should we therefore be surgically removing everyone’s appendix?  Of course not!

By the way,  wisdom teeth evolved in order to eat uncooked prey. I believe the only  uncooked prey which I  along with the vast majority of others on this planet eat, is sushi. I certainly can consume that sushi without help from any third molars.

According to a recent report in Yahoo news, there are about 11,000 cases yearly of permanent nerve damage from wisdom teeth extraction. And of course there are other complications including infection of the gums, jaw and brain, low oxygen from too much anesthesia, bleeding rarely threatening and even death.  Consider also that we Americans plunk down about 3 billion dollars yearly to yank those teeth.  On the other hand,I do n0t doubt that there are times when the wisdom teeth really should be pulled. Take for example if they are impacted,  infected or coming in at unnatural angles.

If they have to come out, ask the oral surgeon if he or she is using local anesthetic plus some narcotics or procedural sedation. Be very careful if the surgeon advices you to use procedural sedation. Remember that propofol of Michael Jackson fame is one of the drugs which can be used in procedural sedation. I question whether procedural sedation should be performed anywhere but in a facility with trained doctors, nurses and assistants with the proper equipment for rescuicitation (read hospital or outpatient surgery facility). Many of the deaths from wisdom teeth extraction are from complications of procedural sedation. Is your oral surgeon ACLS certified? Are there trained assistants who know what to do in an emergency? Can a breathing tube be placed in an emergency? If the answer to any one of these questions is no , then opt for the safer, cheaper way of local anesthetic and pain meds.

The bottom line is that you should think long and hard before opting to pull those wisdom teeth out. I wish in hindsight that I had done so.