SAMA HOOLE: American surgeons pull around 10 million wisdom teeth a year, mostly from teenagers. Jay Friedman, a public health dentist who spent three decades fighting the practice, worked out that at least two-thirds of them were doing no harm whatsoever.

American surgeons pull around 10 million wisdom teeth a year, mostly from teenagers. Jay Friedman, a public health dentist who spent three decades fighting the practice, worked out that at least two-thirds of them were doing no harm whatsoever. The reasoning is an old one. Everybody's go eventually, so have the lot out young, the sound ones with the bad, before they cause trouble. Four at once, usually under a general anaesthetic, followed by a week of soup, ice packs and photographs of chipmunk cheeks. It is so routine that the teenager who keeps all four is the one who gets asked questions. In 2007 Friedman added it all up and called it a public health hazard. About 5 million Americans go under every year, at a cost of over $3 billion. They lose around 11 million days a year to pain, swelling and missed school or work. Tens of thousands are left with lifelong damage, many with a lip, chin or tongue that never gets its feeling back because the drill clipped a nerve. Most of the pain blamed on wisdom teeth, he found, was caused by the surgery. Then came the comparison his profession hated most. The share of wisdom teeth that ever turn nasty is about the same as the share of appendixes that turn into appendicitis, and nobody takes every teenager's appendix out just in case. By his estimate the average oral surgeon in America was making about half a million dollars a year from wisdom teeth. His colleagues called him a traitor. The following year the American Public Health Association came out against pulling healthy wisdom teeth. Britain had got there first. The very first ruling NICE ever issued, in 2000, told dentists to leave healthy wisdom teeth where they were. America carried on, and still does. Wisdom teeth arrive on schedule in every mouth. What has changed is the jaw they are meant to fit into. A jaw grows to the work a child's food gives it, and years of soft, sweet, mushy food build one too small for the teeth it was always going to grow. Impacted wisdom teeth are rare in skulls from before farming. In ours they are a rite of passage. The face shrank to fit the food, and the teeth that no longer fit the face come out at seventeen, as a precaution, at a profit. Every generation finds a new set of teeth to blame for the menu.

— Sama Hoole (@SamaHoole) November 11, 2026

American surgeons pull around 10 million wisdom teeth a year, mostly from teenagers. Jay Friedman, a public health dentist who spent three decades fighting the practice, worked out that at least two-thirds of them were doing no harm whatsoever. The reasoning is an old one. Everybody's go eventually, so have the lot out young, the sound ones with the bad, before they cause trouble. Four at once, usually under a general anaesthetic, followed by a week of soup, ice packs and photographs of chipmunk cheeks. It is so routine that the teenager who keeps all four is the one who gets asked questions. In 2007 Friedman added it all up and called it a public health hazard. About 5 million Americans go under every year, at a cost of over $3 billion. They lose around 11 million days a year to pain, swelling and missed school or work. Tens of thousands are left with lifelong damage, many with a lip, chin or tongue that never gets its feeling back because the drill clipped a nerve. Most of the pain blamed on wisdom teeth, he found, was caused by the surgery. Then came the comparison his profession hated most. The share of wisdom teeth that ever turn nasty is about the same as the share of appendixes that turn into appendicitis, and nobody takes every teenager's appendix out just in case. By his estimate the average oral surgeon in America was making about half a million dollars a year from wisdom teeth. His colleagues called him a traitor. The following year the American Public Health Association came out against pulling healthy wisdom teeth. Britain had got there first. The very first ruling NICE ever issued, in 2000, told dentists to leave healthy wisdom teeth where they were. America carried on, and still does. Wisdom teeth arrive on schedule in every mouth. What has changed is the jaw they are meant to fit into. A jaw grows to the work a child's food gives it, and years of soft, sweet, mushy food build one too small for the teeth it was always going to grow. Impacted wisdom teeth are rare in skulls from before farming. In ours they are a rite of passage. The face shrank to fit the food, and the teeth that no longer fit the face come out at seventeen, as a precaution, at a profit.  

Every generation finds a new set of teeth to blame for the menu.