The wisdom teeth debate continues

Dec. 3, 2012
Rogue dentist’s 30-year crusade against wisdom teeth removal extracts results

Dr. Jay Friedman relishes his role as dental outcast. Like a pesky younger brother who enjoys watching his siblings squirm, the 86-year-old dentist and public health advocate has for decades been poking and prodding at the oral health community over his personal obsession: wisdom teeth.

Friedman has argued for more than 30 years that removing a young person's healthy wisdom teeth -- called "third molars" by professionals -- is an unnecessary and irresponsible practice. While many dentists and oral surgeons have dismissed him as a traitor and a zealot, in 2007, people in the public health arena began to listen.

That's when Friedman published an article in the American Journal of Public Health claiming at least two-thirds of the millions of wisdom teeth extracted each year at a cost of billions of dollars were removed for no good reason. In pointed terms, Friedman accused his colleagues of ignoring the lack of evidence supporting the need for such surgery in order to line their own pockets.

Friedman has compared the practice to prophylactic tonsillectomies, which were routinely performed on healthy children to prevent future throat problems in the first part of the 20th century, before the medical community denounced them as unnecessary.

"There can be no excuse for tolerating so many unnecessary extractions on millions of unsuspecting and misled people and putting them at risk of so much ... nerve injury. This is a public health hazard," Friedman wrote.

The next year, the American Public Health Association adopted a recommendation opposing the prophylactic removal of wisdom teeth and a few insurance plans decided they would no longer cover such extractions.

It's hard to overstate how much these developments have angered oral surgeons.

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