The prophylactic extraction of third molars: a public health hazard.
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.
Friedman
Jay W
JW
drjfriedman@sbcglobal.net
D000293:Adolescent; D000328:Adult; D003777:Dental Prophylaxis / Q000009:adverse effects / Q000941:ethics / Q000706:statistics & numerical data; D020220:Facial Nerve Injuries / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D015994:Incidence; D008964:Molar, Third / Q000473:pathology / Q000601:surgery*; D010292:Paresthesia / Q000453:epidemiology* / Q000209:etiology; D010497:Pericoronitis / Q000453:epidemiology / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011634:Public Health; D018570:Risk Assessment; D012953:Societies, Dental / Q000592:standards; D013515:Surgery, Oral / Q000191:economics / Q000941:ethics / Q000592:standards; D014081:Tooth Extraction / Q000009:adverse effects* / Q000191:economics / Q000706:statistics & numerical data*; D014095:Tooth, Impacted / Q000473:pathology / Q000601:surgery; D006113:United Kingdom; D014481:United States / Q000453:epidemiology; D019564:Unnecessary Procedures / Q000009:adverse effects* / Q000191:economics / Q000706:statistics & numerical data