by Lynn Maleh
Arguments in Favor of Extraction, So They SayWhile your doctor would recommend weighing your options before jumping into surgery, wisdom teeth extractions aren’t given a second a thought with just one word from a dentist. But as with all other surgeries, complications are viable, and considerable risk is involved. And most times, those undergoing wisdom tooth surgery aren’t even experiencing symptoms. Sure, many insurance plans cover the extractions, but does that actually mean they’re necessary?
Though your dentist may be relying on conventional wisdom when recommending extractions, he still needs a “good clinical reason,” says Dr. Greg J. Huang, orthodontics chairman at the University of Washington Seattle. Many doctors support this kind of prophylactic extraction on grounds of future complications, but according to Huang, “Everybody is at risk for appendicitis, but do you take out everyone’s appendix?”
The practice of extraction may have been abandoned in some countries, but many dental experts maintain the tradition. In October 2010, the Surgeon’s Association released a statement titled “Conventional Wisdom and Wisdom Teeth Confirmed: Keeping Wisdom Teeth May Be More Harmful Than Previously Thought.” The statement listed the following points in favor of extraction:
- An absence of symptoms does not equal the absence of disease.
- Eighty percent of young adult subjects who retained previously healthy wisdom teeth had developed problems within seven years.
- Extracting wisdom teeth in young adults produces less pain and shorter healing times than in older patients.
- Monitoring retained wisdom teeth may be more expensive than extraction over a lifetime.
- Most patients (60 percent) with asymptomatic wisdom teeth prefer extraction to retention.
- Retaining wisdom teeth can increase the risk for broader conditions including preterm birth and cardiovascular disease.
But despite these findings, the association never produced hard evidence for their claims. According to Janice Teplitz, associate executive director of communications, “We were not able to locate the reference for it, and subsequently deleted the statement from our Web site.” To this day, there is no official single randomized clinical trial proving either wisdom right or wrong.
So What’s Really Going On?
Further evidence from the Cochrane Collaboration in 2005 claims extraction procedures could be cut down by sixty percent if only used on patients suffering from wisdom tooth related symptoms. It also points to evidence confirming that “removing wisdom teeth does not prevent or reduce crowding of front teeth.”
Three years later, in 2008, the American Public Health Association devised a new wisdom teeth related policy. According to the association, the risks of wisdom teeth extraction surgery, including potential nerve damage, loss of taste, anesthesia complications, and rare – but possible – death, outweigh the potential complications of wisdom teeth-induced periodontal disease.
While extraction reviews are mixed, you still have to make a decision. But before you jump into surgery, ask your doctor the following:
- What will you, in your particular condition (whether showing symptoms or not), specifically gain from undergoing this surgery?
- Is there a chance of the wisdom teeth growing and keeping healthy without surgery?
- Is “watchful waiting” paired with regular dental checkups on option?
- Are there less-invasive options?
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