Did you know that the frequency of wisdom teeth removals varies greatly from one country to the other?

It does. A lot, actually. And this only shows how baseless and unnecessary the removal of third molars often is. If removing them “for prevention” was really good and necessary, that practice would be common all over the world. However, it is not.

As usual, here I will only expose my personal opinion and my appreciations. Know that just like Juan Sebastián Elcano was not a better explorer than James Cook, I am not a better dentist than yours. And if you have a different impression, opinion or appreciation, you can always contact me and let me know. Where are you from, and how many people around you have gotten their wisdom teeth removed for no particular reason? I want to know.

Also, I haven’t been able to find epidemiological studies on the percentage of people that undergo the removal of their wisdom teeth in different countries or environments. If you are aware of any such study, make sure to let me know about it too.

But it is still very obvious, for anybody that has paid attention to the matter, that the frequency of such “preventive” (i. e., unnecessary, unjustified) removals changes a lot from one country to the other.

The United States of America is probably the world leader of unnecessary wisdom teeth removals. I would even list it along unaffordable medical costs, obesity rates or the opioid crisis as one of the main health hazards that affect America today. Jay W. Friedman also said it was a health hazard back in 2007. It is unclear if things have improved (or worsened) ever since.

Asaf Cygelberg conducted a poll in 2024 and found that 67% of American respondents had gotten at least a wisdom tooth removedThat’s a lot. And no, this statistic doesn’t prove that wisdom teeth are awful: it shows that American people tend to get them removed a lot more than it is actually necessary. This isn’t even a new kind of medical problem: the exact same thing used to happen with tonsils a long time ago.

This is also what American people tell me. It is also my personal appreciation… and not only my own:

Be aware of this, my dear reader, if you happen to live in the USA and have been recommended to get your wisdom teeth removed. Do you have any particular problem? “Lack of space” or “maybe future problems” are not real problems. I mean something like pain, an infection, a real pathology. If you have nothing like this, there is a huge chance that if you were in some other country, with your mouth being exactly like it is right now, you would never be proposed to get your wisdom teeth removed.

This is absurd. They are suggesting you to remove teeth that are fine “just in case”. You shouldn’t agree to it.

This is not exclusively an American problem, though. The prophylactic removal of wisdom teeth seems to be common in Australia too, with a huge number of people getting hospitalized to get their third molars removed there. You can read a study on this topic here, and also consult this summary table.

It is happily less common in the United Kingdom, where the National Institute of Clinical Excellence (NICE) set coherent and respectful guidelines to deal with wisdom teeth. You can consult them, along with many other interesting and relevant guidelines and studies, in the Resources section. Remember that my opinion is backed by evidence and official guidelines.

I am Spanish. I studied and lived for many years in Spain. I am still closely tied to Spain and the Spanish people. I have spent hundreds of hours observing the job of other dentists and surgeons in Spain. And I can assure you that the prophylactic removal of third molars is way less common in Spain than in America… or in France, where I currently live and practice.

Here in France, I see patient after patient that underwent the removal of all their four wisdom teeth, literally for no valid reason at all. The myth of wisdom teeth being able to push and cause dental crowding was particularly popular and believed here, taught as truth at Orthodontics schools, and still widely believed by dentists and patients alike. Every day, at my practice, I do my part to try and educate the public about this.

Interesting fact, though: I noticed a much higher proportion of my patients having gotten their wisdom teeth removed in the city of Brest, where I used to work, than in the rural area where I currently work. I imagine there aren’t only differences between countries, but also differences between regions or social groups within the same country.

And speaking of social groups, France and the USA seem to have something in common: the amount of people that get their wisdom teeth removed to enter the military. I have seen plenty of military men as patients here in France (especially in Brest, where there is an important naval base), and I have read many such testimonies from people joining the US Marine Corps.

This is pretty much unheard of in other countries. I have even read testimonies of people joining the Spanish Armed Forces with partially impacted wisdom teeth (poking through, without space for them to fully come in, like mine), without an issue. They had no symptoms or infections, so they weren’t required to take them out. Obviously!

The previous study on Nature shows that the rate of people hospitalized in France to get their wisdom teeth removed is also very high. I can confirm this on the terrain: I have met plenty of people that got general anesthesia (no less!) to get all their four wisdom teeth removed. And the most popular answer I get when I ask my patients why they got the removal done, is, by far: “Parce qu’elles n’avaient pas de place”, “because they had no place”. And I am talking about people with otherwise healthy teeth, with no history of infections or pain, or any real problem. This is insane! “No place” is not a valid reason to get a wisdom tooth removed.

On the other hand, in Spain, things are not like this. During our clinical training in university, we never addressed anybody to the Surgery master’s degree to get asymptomatic wisdom teeth removed.

As part of my training, I also spent a few days observing the work of a public dentist (working for the Social Security). Public dentists in Spain are basically “extractionists”: they only do removals. So, I saw a lot of teeth getting removed. Can you guess how many of them were healthy wisdom teeth, for the sake of prevention? Zero.

I also spent a few days at the Virgen de las Nieves Hospital in Granada, with the doctors at the Maxillofacial service. I saw multiple orthognatic surgeries, and I saw a complicated case of recurring cranial abscesses that didn’t respond well to draining or antibiotics. But do you know how many removals of wisdom teeth I saw, after spending days at a whole MAXILLOFACIAL service? Zero.

And in Roquetas de Mar, when I was in ESO and Baccalaureate, roughly equivalent to Middle and High School in America, I don’t recall any of my schoolmates getting their wisdom teeth removed. Even if plenty of them did wear braces, for instance. Believe me: I already paid attention to these things.

I also have a pretty eloquent anecdote to share: my barber is Russian. One of the times I went to get my hair cut, I told him of this website that I was planning to launch back then. He said that, living in Russia, he had barely ever heard of wisdom teeth, or Зуб мудрости. Having little dental knowledge, he barely knew what they were. It was only when he arrived in France, where there is an "epidemic" of unnecessary removals, that he began hearing of dents de sagesse and their removal all the time.

I have heard that in Sweden, people under 23 get “free” dental treatments, covered by the state. I am afraid that this might push some young people to rush up and get their wisdom teeth removed “while it’s free”, without a real and solid medical reason. But I don’t know if this is actually the case. If you live in Sweden, you may contact me and tell me what you know about this topic.

Wherever you are, avoid unnecessary dental procedures. Including unnecessary wisdom teeth removals. If you think many people in your environment have gotten them removed… it might be, indeed, that too many have gotten them removed. As almost nobody ever needs to get all four of them removed at the same time. And in general, wisdom teeth don’t cause problems. Wisdom teeth causing problems is the exception to the rule of asymptomatic and healthy wisdom teeth. In fact, most of the people in the world won’t even give their asymptomatic wisdom teeth a thought, and they will be absolutely fine.

And you, my dear reader, will be fine too. Like the Spanish-Argentinian singer Chenoa sings: Tengo historias para comprender que todo te irá bien. Meaning: I have stories to understand that everything will go well for you.

Saludos cordales.

‍