As a young woman my dad always told me when getting my oil changed never to buy any of the extra services they offer. Instead, he said I should tell him about it about it and he would talk to the mechanic about anything serious. While this follows some harmful gender stereotypes it does highlight the asymmetric information between myself and the mechanic. Although my dad is by no means a car expert, he at least knows a smidge more about cars to lessen this gap between the information that the seller and buyer have. When the seller has more expertise on the product they are able to sell you more services, and mechanics are a classic example. This leads to many to have a distrust of their mechanic and for them to get second opinions. Compared to mechanics few distrust their dentists and oral surgeons.
In the United States, wisdom teeth extractions is a common procedure and excuse to eat ice cream for a few days. Right around the time you gain the right to vote, a dentist usually recommends you get your wisdom teeth removed and refers you to an oral surgeon. You set up an appointment and don’t question the procedure. However, Dr. Jay Friedman has been questioning the practice now for almost three decades. Many oral surgeons are mad about this too as much of their livelihood depends on the routine extraction of wisdom teeth.
This rogue dentist published an article in the “US National Library of Medicine National Institutes of Health” 12 years ago about this issue of asymmetric information. “The Prophylactic Extraction of Third Molars: A Public Health Hazard” outlines the costs and myths of wisdom teeth removal. While some patients do need their wisdom teeth removed for health reasons, many people get they wisdom teeth removed routinely without any evidence that it would cause any problems. Friedman writes, “Two thirds of all third-molar extractions are unnecessary. Eliminating these extractions would reduce the oral and maxillofacial surgeon’s annual income by $347,486, resulting in an annual savings to patients of more than $1.9 billion.” This is a lot of money, not to mention pain and sick days, that consumers could save if they avoided unnecessary removal. Often the cost benefit analysis does weigh out to point towards the need of removal. The great pain and dollars spent on removal does not justify the small chance of saving trouble down the road.
While consumers would save, oral surgeons would miss out on profit which is why the practice continues. Oral surgeons are able to get away with it to due to asymmetric information. Since oral surgeons are the most educated on the subject everyone trusts them and follows their advice. Oral surgeons are incentivized to exaggerate the need of wisdom teeth removal as they profit from the procedure. Dr. Jay Friedman has made it his mission to stop this scheme and has been ostracized from the dental community for it. There is hope, wisdom teeth removal has fallen, as the British National Institute for Clinical Excellence discouraged the over extraction and a few organization in the United States have started to follow. You can also do your part and do your own research on wisdom teeth removal to lessen the disadvantage you have when it comes to information compared to your oral surgeon. Of course,while many wisdom teeth are over removed, some removals are necessary. There also ways dentists could teach their patients to floss and brush better so their wisdom teeth do not cause problems but of course this isn’t as profitable as surgery.
