NICE or not so NICE?

This article provides an opinion on the NHS NICE guidance on wisdom tooth removal introduced in 2000. Guidelines should support clinical decision-making by providing recommendations based on sound evidence but the wisdom tooth guidelines were published without any research evidence. General dentists and oral surgeons in England and Wales are under pressure to comply with this guidance but what have been the implications for patient care? There is growing evidence that patients have not been best served, with significant numbers developing caries in an adjacent tooth before consideration of wisdom tooth assessment.