The surgical removal of teeth is one of the four surgical operations included in both top 10 day case and inpatient NHS procedures for England and Wales.1 The other three procedures, for 1989-90, were endoscopic operations on the upper gastrointestinal tract and bladder and evacuation of the contents of the uterus. Surprisingly, in the last year for which statistics are available (1989-90) more than twice as many people (60 000) were admitted for the surgical removal of teeth as were treated as day cases (28 000). For inpatient procedures, the surgical removal of teeth was ninth in frequency behind vasectomy. The surgical removal of third molars (wisdom teeth) accounted for 70% of these procedures in 1989-90. In addition, 67 000 people had their third molars removed by dental practitioners in the general dental service and 22 000 had their third molars removed in the private sector. The total cost of third molar removal in the NHS in 1989-90 was estimated as pounds sterling 23.3m and in the year ended 30 June 1992 was pounds sterling 22m in the private sector.2 In the hospital service, patients waiting for third molar removal account for up to 90% of patients on waiting lists in oral and maxillofacial surgery.3 Although …