Fitness Files: Apply wisdom to your teeth

Remember when we were kids? Everybody had tonsillectomies. Then adenoid surgeries. Then tubes in the ears.

For females, it was the frequent hysterectomy, then so many breast biopsies.

I’m not saying all such surgeries were unnecessary, but perhaps they were over-prescribed.

Here’s something to think about: That often-suggested wisdom tooth extraction may be held off in favor of good dental hygiene, regular tooth cleanings and dental examinations.

Back molars helped our larger-jawed cave-dwelling ancestors chew.

But today, we chew cooked food and listen to dentists’ admonitions regarding future danger of impacted wisdom teeth.

Roni Caryn Rabin’s 2011 piece in the New York Times tells us that Dr. Raymond P. White Jr. of the University of North Carolina School of Dentistry says that 60% to 70% of patients with wisdom teeth “will eventually have trouble with them,” but he acknowledged that that statement is based on limited data.

Supporting White, the American Assn. of Oral and Maxillofacial Surgeons issued a statement declaring, “80% of young adults who retained previously healthy wisdom teeth developed problems within seven years … [which] are extracted up to 70% of the time.”

Those numbers may persuade parents of teenagers to agree to yank the wisdoms out. Not so fast.

“Everybody is at risk for appendicitis, but do you take out everyone’s appendix?” asks Dr. Greg J. Huang, of Seattle’s University of Washington School of Dentistry. Bolstering Huang’s thesis, Dr. Jay Friedman’s September 2007 article in the American Journal of Public Health calls two-thirds of the extractions, equaling $3 billion, unnecessary.

Friedman, who has degrees in dentistry and public health, says that “no more than 12% of impacted teeth have associated pathology.” That means 88% of wisdom teeth probably won’t become impacted or develop cysts or tumors. Friedman quotes the British National Health Service policy, “There is no reliable evidence to support a health benefit to patients for … removal of [healthy] impacted [not fully erupted] wisdom teeth.”

Elise Oberliesen’s Los Angeles Times article last month presents research to counter the claim that wisdom teeth are pulled because of “overcrowding.” Overliesen quotes a 2012 review of randomized clinical trials that “looked at evidence on both sides of the [overcrowding] debate.” It concluded that there were “no sufficient data to suggest that taking out wisdom teeth reduced crowding of the remaining teeth over five years.”

The American Public Health Assn. found that the “single biggest predictor of wisdom tooth surgery is the availability of insurance.”

What’s the lesson here? I do not intend to indict doctors or dentists. I have great respect for scientific study, years of training and experience treating many patients.

However, we are consumers of medical care. Although it is comforting to say, “Whatever you think, doctor,” where surgery is concerned, we need to realize that medical professionals are part of an increasingly tough marketplace. They follow the prevailing wisdom of their associations.

We need to tease out elective procedures from necessary treatments. Second opinions are in order, as is following responsible sources such as major university medical schools, WebMD.com and MedlinePlus.gov. Discuss findings with a doctor or dentist so you make an informed decision.

I still have my wisdom teeth.

Always searching for wisdom.

Newport Beach resident CARRIE LUGER SLAYBACK is a retired teacher who ran the Los Angeles Marathon at age 70, winning first place in her age group. Her blog is [email protected].