The Hazards of Wisdom Tooth Extraction: From Patient to Plaintiff
TASA ID: 170
Ten million "impacted" wisdom teeth are extracted each year from 3.8 million people, 94 percent by oral and maxillofacial surgeons. Studies indicate that one-third of a percent (0.33%) to one percent of the patients (12,500 to 38,000) suffer permanent injury, mostly damage to the mandibular or lower jaw nerve, resulting in varying degrees of numbness (paresthesia) of the lip and chin, distortion of speech and smiling, cheek biting, difficulty chewing, and, in some cases, severe shooting neuralgic pain. Tens of thousands of people may also suffer lingual (tongue) nerve and TMJ or temporomandibular (jaw) joint injury.
Most of the third molar extractions are not impacted teeth. They will grow into normal position if left alone. The oral surgeons contend that early extraction, before the teeth are erupted and fully formed, reduces the pain of surgery and the risk of injury. This contention is not "evidence-based." On average, patients suffer over 2 days of pain and disability and loss of school and work, following uncomplicated extraction of wisdom teeth, at least two-thirds of which is unnecessary.
If all third molar extractions were necessary, no one would fault the oral surgeons. However, at most, only one-third of these teeth cause chronic pain or infection, as opposed to natural teething discomfort during eruption, cysts, or damage to adjacent teeth, and, therefore, would require removal. But the idea that all wisdom teeth should be removed in the absence of any recognizable pathology, whether or not impacted, or while they are still in the developmental stage, is a myth perpetrated by oral surgeons in private practice, who, coincidentally, receive as much as three-fourths of their income, averaging nearly three-quarters of a million dollars gross income for the 6000 oral surgeons in the United States, from this procedure. They also promote unnecessary general anesthesia, which has its own inherent risks of injury and death, even though most extractions can be done easily and more safely with a local anesthetic injection.
The American Association of Oral and Maxillofacial Surgeons argues that periodontal (gum) disease may originate with wisdom teeth, possibly leading to heart disease and other maladies; they should be removed at an early age. If that were a valid argument, all teeth with periodontal disease would be removed, and there would be no need for periodontists and dental hygienists who treat and retain these teeth. The oral surgeons contend that because one cannot tell which wisdom teeth will become pathological, all wisdom teeth should be extracted. But the same unpredictability applies to the tonsils, the appendix, the gall bladder, the uterus, and female breasts. Yet no responsible person suggests removing these structures because a small percentage of them might become diseased in the future. Surgery to prevent future pathology is irresponsible and tantamount to malpractice, particularly when removal of non-pathological, asymptomatic structures, in this case, third molars, results in iatrogenic injury.
It is likely that most patients, or their surrogate parents, sign a consent form that does not provide sufficient information, even if they read it, to make a truly informed decision. They are not told that evidence-based practice--the gold standard of ethical medical/dental practice--does not support prophylactic removal of nonpathologic, asymptomatic wisdom teeth, whether unerupted, erupted, partially or fully impacted. They are told that because one tooth is causing a problem, the other third molars need to be removed to prevent future problems, even though the risk of injury from the surgery is as great or greater than the risk of pathological developments. They are told that failure to extract the wisdom teeth might lead to gum and jaw disease, as well as crooked front teeth. In other words, prospective patients are fed false or misleading information to coerce them into extraction of all their wisdom teeth. When the consequence of misinformed consent results in permanent injury to sensory nerves, diminishing the quality of life, the injured patient may well become a plaintiff.
This article discusses issues of general interest and does not give any specific legal, medical, or business advice pertaining to any specific circumstances. Before acting upon any of its information, you should obtain appropriate advice from a lawyer or other qualified professional.
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