Several weeks ago, a high school senior from Long Island died two days after wisdom tooth surgery. As a parent I ache for his family. As a physician, I wonder about the circumstances.

I have no direct knowledge about the student’s condition prior to his surgery, the surgery itself, or what happened afterward. I do know that, according to an article in the American Journal of Public Health 2007, upwards of two-thirds of routine third molar extractions performed in the U.S. are not needed.

How can this be? How can $2 billion a year in unnecessary and non-indicated surgeries to extract wisdom teeth be done each year?

As a practicing orthopaedic surgeon, I can relate that a number of techniques and practices I was taught in good faith 20 years ago are now known to be ineffective or even harmful. This is true across the field of medicine. After all, 300 years ago common practice included “bloodletting” patients when they were sick, leading to the death of our first president, George Washington.

The American Public Health Association opposes prophylactic removal of wisdom teeth. The British National Institute for Clinical Excellence states rather bluntly that “the practice of prophylactic removal of pathology-free impacted third molars should be discontinued.”

In this era of shared decision making, it is important to be skeptical. This is especially the case when it comes to elective surgery to take care of a “problem” that may not be a problem at all.

Dr. Stephen J. Barr
North Yarmouth

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