An Australian perspective of removing or retaining wisdom teeth (third molars)

An article titled “Cost effectiveness modelling of a ‘watchful monitoring strategy’ for impacted third molars vs prophylactic removal under GA: an Australian perspective” appeared in the July 2015, British Dental Journal and written by A.A. Anjrini, E. Kruger, and M. Tennant (issue 219, pp. 19-23). The article discusses the direct and indirect costs associated with removing impacted wisdom teeth in Australia. A news article appearing on the Australian ABC Science ( titled “Wisdom teeth: are we removing them more often than needed?” by Anna Salleh and written on August 17, 2015, discusses some of the points made in the journal article.

The authors were interested in determining if a watchful waiting monitoring strategy should be used for impacted wisdom teeth or if a prophylactic strategy should be used. They looked at hospitalization data for impacted wisdom teeth removal for 2008 and 2009. They then calculated cost estimates for a one year watchful waiting strategy and a 20 year watchful waiting strategy. The authors estimated an individual cost of watchful waiting as $1,077 for a 20 year period and of $53 for a 1 year period.

The authors propose moving to a watchful waiting monitoring strategy approach to the removal of asymptomatic wisdom teeth in Australia. They calculated that this will lead to an annual reduction of costs between $420 million and $513 million for Australia. This is partially motivated because surgery of wisdom teeth can lead to potential complications.

From this study it appears that the authors feel the guidelines from the UK National Institute for Health and Care Excellence for wisdom teeth management are appropriate. In their calculations the authors suggest that new dental x-rays to monitor wisdom teeth should occur every 2 years. Of course this study is not without controversy. The president of the Australian Dental Association Rick Olive argues this approach like the one taken in the U. K. (United Kingdom) is just a cost savings exercise. He says “this is the argument that is used by those who seek to ration healthcare.” Rick Olive suggests there is not enough evidence from research to suggest what to do in the case of asymptomatic impacted wisdom teeth. As such a decision should be made by patients with input from their dentists.

To see more discussion of some of the controversy surrounding wisdom teeth removal see

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