Os adultos se arrependem de ter extraído profilaticamente os dentes do siso assintomáticos — ou de mantê-los e vigiar?
Se você agir
Extrair profilaticamente os dentes do siso assintomáticos
36%
Se você não agir
Manter os dentes do siso assintomáticos e vigiar
64%
Porcentagem de quem mais tarde se arrepende de cada escolha. As barras e o registro completo aparecem abaixo.
Saúde
Última revisão 2026-07-14
Qualidade das evidências 4.25/5
Pontuação de revisão em oito dimensões segundo a
grelha de qualidade
. Cada dimensão pontuada de 1 a 5.
D1 Verificação das fontes
5/5
D2 Autoridade e independência das fontes
4/5
D3 Precisão da taxa de arrependimento
3/5
D4 Comparabilidade das fontes
5/5
D5 Padrão de Gilovich
5/5
D6 Qualidade da prosa
4/5
D7 Completude das ressalvas
4/5
D8 Qualidade da amostra
4/5
Média4.25/5
Dados proxy — não existe nenhuma pesquisa direta sobre arrependimento para esta decisão. As taxas são derivadas de pontuações de satisfação e dados de barreiras de acesso em vez de perguntas que perguntavam diretamente sobre arrependimento. Veja advertências abaixo.
Arrependimento por ação
Extrair profilaticamente os dentes do siso assintomáticos
36%
~36% dos dentes do siso extraídos profilaticamente não teriam precisado de extração em 18 anos — uma operação (com sua taxa de ~4% de complicações) feita num dente que nunca deu problemas (proxy de cirurgia desnecessária)
Adultos jovens com terceiros molares assintomáticos; complemento da taxa acumulada de extração em 18 anos
num horizonte de 18 anos
Arrependimento por omissão
Manter os dentes do siso assintomáticos e vigiar
64%
~64% dos dentes do siso assintomáticos mantidos acabam extraídos mesmo assim em 18 anos — vigiar costuma adiar a operação em vez de evitá-la (proxy de extração adiada)
Adultos jovens que mantêm terceiros molares assintomáticos; taxa ancorada no número acumulado dos sete estudos agrupados por Bouloux 2015 (cada estudo com ≥50 sujeitos), não numa única coorte
acumulado em 18 anos de acompanhamento
% se arrependem desta escolha
Extrair profilaticamente os dentes do siso assintomáticosManter os dentes do siso assintomáticos e vigiar
36%64%
inaction dominates — A inacção domina — a maioria arrepende-se de não ter agido.
Decisões relacionadas
Decisões semanticamente semelhantes — mesmo terreno, compromissos diferentes.
Keeping asymptomatic wisdom teeth and watching is the choice that most often fails to close the matter: across seven longitudinal studies, about 64% of retained symptom-free third molars are extracted within 18 years, at a steady rate of roughly 3% per year (Bouloux et al., 2015). A same-era 18-year cohort found 73% of the teeth that were unerupted at baseline came out before follow-up ended (Ventä et al., 2004), though that study’s follow-up window overlaps the period Bouloux pooled, so the two are better read as consistent than as independent. The reasons are ordinary: caries, gum disease, later inflammation, and part of that 64% is care that was simply timed to need rather than regretted. The practical upshot is that watching usually defers the operation rather than avoiding it, and the extraction then falls later in life rather than in early adulthood.
Removing the tooth up front does not escape regret either; it relocates it. Because prophylactic removal is itself an extraction, its regret falls on the mirror-image group: the roughly 36% of removed teeth that would have stayed trouble-free over the same 18 years, operated on for nothing. Every one of those extractions carries about a 4.2% chance of a complication, overwhelmingly dry socket, with infection and jaw-joint symptoms far behind (Chen et al., 2021). The Cochrane review found only two studies and 493 people bearing on whether disease-free impacted wisdom teeth should come out at all, and rated the evidence very low certainty (Ghaeminia et al., 2020). NICE went further in 2000, concluding that prophylactic removal of pathology-free impacted third molars should be discontinued in the NHS — a position US practice frequently sets aside.
The two figures are close on purpose, because the decision is close. Both come from the same fact: about two-thirds of these teeth eventually need removal and about a third do not. Watch, and you carry a 64% chance of the surgery you were trying to avoid; remove, and you carry a 36% chance the surgery was needless. Severity runs opposite to frequency — the deferred operation is common but often appropriate, while the unnecessary one is rarer but incurred up front against a benefit the evidence cannot show. What survives the symmetry is a modest lean, consistent with Gilovich and Medvec’s temporal asymmetry: over a long horizon, more people end up back in the chair than are spared it. Whether that reads as regret or as a reasonable bet that mostly postponed a minor operation is the judgement the evidence declines to settle.
Fontes: acção
Registro de evidências
Cada número abaixo é o que cada fonte relatou, com a citação literal em que nos baseamos e como chegamos ao nosso valor. Clique em qualquer link para verificar diretamente.
[1]Journal of Oral and Maxillofacial Surgery (Bouloux et al. 2015) — What is the risk of future extraction of asymptomatic third molars? A systematic review
Revisado por pares
Seven longitudinal studies, follow-up 1 to 18 years: cumulative extraction incidence rose from 5% at 1 year to 64% at 18 years — leaving ~36% of retained asymptomatic third molars still not extracted at 18 years
Trecho
“"The mean incidence rate for M3 extraction of previously asymptomatic M3s was 3.0% annually (range 1 to 9%). The cumulative incidence rate for M3 removal ranged from 5% at 1 year to 64% at 18 years. ... The cumulative risk of M3 extraction for young adults with asymptomatic M3s is sufficiently high to warrant its consideration when reviewing the risks and benefits of M3 retention as a management strategy."
”
Dados da fonte de
2015-05-01
Acessado
2026-07-14
Cálculo
The action-side proxy is the mirror image of the inaction figure. If 64% of retained asymptomatic third molars are extracted by 18 years, then roughly 36% are not — those teeth would have stayed trouble-free over that horizon, so removing them prophylactically was, in hindsight, an operation for nothing. We anchor the action proxy at 0.36, the complement of Bouloux's 64% cumulative extraction rate. This is an "unnecessary-surgery" proxy, not a regret survey, and 0.36 is an upper bound: over a full lifetime the never-needed fraction shrinks, because some of that 36% would eventually have required extraction after 18 years. Using the same dataset for both sides keeps the two proxies on one axis.
[2]National Institute for Health and Care Excellence (NICE), UK — Guidance on the extraction of wisdom teeth (Technology appraisal guidance TA1)
Relatório governamental
National guidance: the practice of prophylactic removal of pathology-free impacted third molars should be discontinued in the NHS; surgery limited to teeth with evidence of pathology
Trecho
“"The practice of prophylactic removal of pathology-free impacted third molars should be discontinued in the NHS. ... Surgical removal of impacted third molars should be limited to patients with evidence of pathology. ... A first episode of pericoronitis, unless particularly severe, should not be considered an indication for surgery."
”
Dados da fonte de
2000-03-27
Acessado
2026-07-14
Cálculo
The policy basis for treating prophylactic removal as regret-prone. A national appraisal body concluded that routinely removing symptom-free impacted third molars should stop, because the benefit is unproven while every extraction carries surgical risk. US practice frequently diverges, which is why this decision is genuinely contested. Establishes the frame; not a rate.
[3]PLOS ONE (Chen, Chi & Lee 2021) — Revisit incidence of complications after impacted mandibular third molar extraction: A nationwide population-based cohort study↗ 1 other entry
Revisado por pares
“"The overall cumulative complication rate for iLM3 extraction was 4.2%. ... The incidence of DS was the highest (3.66%) ... the incidence of SSI was very low (0.17%) ... about 4 out of 1000 patients had temporomandibular joint symptoms and sought treatment (0.41%)."
”
Dados da fonte de
2021-02-22
Acessado
2026-07-14
Cálculo
Quantifies what an unnecessary extraction costs. Every prophylactic removal — including the ~36% that were never needed — runs about a 4.2% chance of a complication, dry socket being the commonest and generally self-limiting. Permanent nerve injury is rarer, a few per thousand. Note the population: this cohort is all impacted lower-molar extractions, mixed symptomatic and asymptomatic, not solely prophylactic cases, so the 4.2% is a general operative-risk figure, not a rate specific to the unnecessary subset. Supplies the severity of the action harm, not its frequency.
[4]Cochrane Database of Systematic Reviews (Ghaeminia et al. 2020, CD003879) — Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth
Revisado por pares
Two included studies (one RCT with 77 adolescent participants analysed; one prospective cohort of 416 healthy males aged 24–84): only low- to very-low-certainty evidence; insufficient to determine whether asymptomatic disease-free impacted wisdom teeth should be removed or retained
Trecho
“"This review update includes the same two studies that were identified in our previous version of the review ... We found only low- to very-low-certainty evidence of the effects of removal compared with retention ... Insufficient evidence is available to determine whether asymptomatic disease-free impacted wisdom teeth should be removed or retained."
”
Dados da fonte de
2020-05-04
Acessado
2026-07-14
Cálculo
The evidentiary weight behind the action-side regret framing. The benefit a prophylactic extraction is meant to buy — preventing future disease — cannot be demonstrated: the whole randomised-plus-cohort evidence base is two studies and 493 participants, rated low to very low certainty. This is why removing a symptom-free tooth is treated as regret-prone rather than clearly protective. Establishes the strength of the evidence, not a rate.
Fontes: inacção
Registro de evidências
Cada número abaixo é o que cada fonte relatou, com a citação literal em que nos baseamos e como chegamos ao nosso valor. Clique em qualquer link para verificar diretamente.
[1]Journal of Oral and Maxillofacial Surgery (Bouloux et al. 2015) — What is the risk of future extraction of asymptomatic third molars? A systematic review
Revisado por pares
Seven longitudinal studies, follow-up 1 to 18 years: mean extraction incidence 3.0% per year (range 1–9%); cumulative extraction incidence rose from 5% at 1 year to 64% at 18 years
Trecho
“"The mean incidence rate for M3 extraction of previously asymptomatic M3s was 3.0% annually (range 1 to 9%). The cumulative incidence rate for M3 removal ranged from 5% at 1 year to 64% at 18 years. ... The cumulative risk of M3 extraction for young adults with asymptomatic M3s is sufficiently high to warrant its consideration when reviewing the risks and benefits of M3 retention as a management strategy."
”
Dados da fonte de
2015-05-01
Acessado
2026-07-14
Cálculo
The inaction-side proxy. Retained asymptomatic third molars are extracted at about 3% per year, so the cumulative share removed climbs to 64% by 18 years. We anchor the inaction proxy at 0.64, taken directly from this figure. The regret construct: watching does not usually spare the surgery, it defers it, and the extraction then happens later in life. (Conventional oral-surgery teaching holds that later extraction in an older patient is harder, though Chen 2021 — cited below — found no age association with complications in its own cohort, so we do not lean on that claim.) This is a "needed extraction anyway" rate, not a survey asking whether people regret having waited, and part of that 64% is appropriately-timed care rather than a mistake.
[2]Journal of Oral and Maxillofacial Surgery (Ventä, Ylipaavalniemi & Turtola 2004) — Clinical outcome of third molars in adults followed during 18 years
Revisado por pares
118 subjects followed from mean age 20 to 39: 73% of initially unerupted third molars and 64% of initially partially erupted third molars were removed during the 18-year follow-up (maxilla and mandible combined)
Trecho
“"Most of the initially unerupted third molars were removed during the follow-up period (73%, maxilla and mandible together). ... More than half of the initially partially erupted third molars were removed during the follow-up period (64%, maxilla and mandible together)."
”
Dados da fonte de
2004-02-01
Acessado
2026-07-14
Cálculo
A same-order-of-magnitude 18-year cohort: 118 adults tracked from a mean age of 20 to 39, most third molars unerupted at baseline ending up removed (roughly two-thirds to three-quarters over ~18 years). Treat this as consistency, not clean independent replication: Bouloux 2015 is a systematic review whose only 18-year datapoint plausibly draws on this same cohort, so we cannot confirm this is a wholly separate measurement of the 64%. Small sample; supports the direction of the inaction proxy, not an independent rate.
Ressalvas
Ambos os números são proxies extraídos do mesmo fato subjacente — que cerca de 64% dos terceiros molares assintomáticos mantidos são extraídos em 18 anos (Bouloux 2015; consistente com a coorte de Ventä 2004, cuja janela de 18 anos pode se sobrepor aos estudos agrupados por Bouloux) — de modo que se situam num mesmo eixo, mas nenhum dos dois é uma pesquisa de arrependimento. Os 64% da inação são uma taxa de "no fim você precisou da cirurgia"; os 36% da ação são o seu complemento, a parcela de dentes extraídos profilaticamente que teria permanecido quieta no mesmo horizonte, uma operação feita para nada. A comparação é deliberadamente apertada porque a decisão é apertada: a extração profilática é, ela própria, uma extração a 100%, então vigiar nunca sai pior no eixo de "evitar a cirurgia" — dá ~36% de chance de nunca precisar da operação e ~64% de chance da operação que se teria de qualquer forma, apenas mais tarde. É por isso que o delta é modesto e não desequilibrado, e por isso nenhum lado vence com clareza. A gravidade corre em sentido oposto à frequência: o dano da ação é incorrido antecipadamente, numa boca mais jovem e mais fácil de operar, em troca de um benefício que a revisão Cochrane (Ghaeminia 2020 — apenas 493 participantes em dois estudos, certeza muito baixa) não consegue demonstrar; o dano da inação é mais comum, mas frequentemente é apenas um adiamento, e parte desses 64% é cuidado prestado no momento certo, depois de o dente realmente adoecer, não um erro lamentado. O número de 36% da ação é um limite superior por duas razões. Primeiro, ao longo da vida mais dentes mantidos acabam precisando de remoção, encolhendo a parcela dos que nunca precisariam. Segundo, ele toma emprestada a taxa da coorte de retenção, mas os dentes efetivamente escolhidos para extração profilática não são uma amostra aleatória — os clínicos tendem a remover a anatomia de maior risco (impactação profunda, angulação mesioangular, contato estreito com o segundo molar), que tem mais probabilidade de causar problemas depois. Assim, a parcela de "nunca necessários" entre os dentes que realmente são removidos provavelmente fica abaixo de 36%, e esse viés de seleção para o tratamento pesa contra o lado da ação. Os 4,2% de complicações de Chen vêm de todas as extrações de molares inferiores impactados, misturando casos sintomáticos e assintomáticos, não apenas profiláticos. Trata-se de uma decisão genuinamente disputada — o NICE concluiu em 2000 que a remoção profilática de terceiros molares impactados sem patologia deveria ser abandonada no NHS, enquanto a prática americana os remove com frequência. As populações são taiwanesa, finlandesa e internacionais agrupadas, não americanas. A direção de predomínio da inação é consistente com o quadro de assimetria temporal de Gilovich e Medvec, mas aqui é estreita e depende de como se pesa um adiamento comum contra uma operação desnecessária antecipada, mais rara.
