In an effort to resolve the controversy the National Institute of Health held a conference in 1979. It was agreed that straight healthy wisdom teeth should be left alone and that those that are diseased or causing trouble for other teeth should be removed. But the main issue, whether impacted but otherwise healthy wisdom teeth should be pulled to prevent trouble was never resolved.

"The panel waffled on this issue." Said Dr. Walter C. Guralnick, a co-chairman of the meeting. After long discussion the, the panel reluctantly agreed, "Impaction or malposition of a third molar is an abnormal state and may justify its removal.

Dr. Guralnick. Professor emeritus of maxillofacial surgery at the Harvard School of Medicine, recently explained, "There has never been a good prospective study done to determine what percentage of people get into trouble if impacted wisdom teeth are left in place.

No such study had begun before 1979 conference, and despite the panel's recommendation none have been started since. Such a study would follow large numbers of people for many years to see what happens to their impacted wisdom teeth. Experts now have only on e small study from which to judge; in it, most other 60-to 70- year- olds who still had their wisdom teeth had no evident disease in their impacted teeth.

Not unexpectedly, American Association of Oral and Maxillofacial surgeons recommends early removal of impacted wisdom teeth. Dr. Guralnick, who departs from this advice unless the teeth have partly emerged, nonetheless believes that the surgeons arrived at it honestly, using years of clinical experience as their bases.

"The economics of clinical practice is not the primary reason for the surgeons' view," he insisted. "Oral surgeons today have enough other ways to earn a good living. They don't depend on pulling wisdom teeth."

Still, more than half of all Americans seem to wait until problems arise that force the issue, the oral surgeons report.

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