10 million wisdom teeth are removed each year. That might be way too many.

Each year, five million people have wisdom teeth removed, but it’s up in the air whether all of those surgeries were necessary.

Wisdom teeth, also called the third molars, are four teeth that grow at the very back of each corner of the mouth. For most people, they start to grow in between ages 17 and 25. They’re thought to crowd out other teeth or cause tooth decay, which is why many dentists and oral surgeons think it’s better to just nip those problems in the bud and take them out as a preventative measure.

But there’s a serious debate between dentists and oral surgeons: should they preemptively remove someone’s wisdom teeth if the patient doesn’t have any symptoms?

Simply put, there’s no right answer. It comes down to what you, as a patient, want. Here’s what you need to know to figure that out.

Dentists and oral surgeons agree across the board that there’s cause to remove wisdom teeth if a patient is in pain or if there are signs of disease popping up, like tooth decay or infection. That’s an obvious choice. But taking out wisdom teeth when there aren’t any symptoms is where the professionals get into it.

Many dental professionals stick with a watch and wait approach with wisdom teeth to avoid surgery if possible. “Many people don’t have adequate space in their jaw for the teeth to come into full position, but that alone isn’t justification of having them all removed,” says Dr. Scott Tomar of University of North Carolina’s School of Dentistry. Tomar says that as a dentist he feels the risks of complication, including infection and hitting nerves during surgery, outweigh any benefits of preventative removal.

In 2007, oral surgeon Dr. Jay Friedman called the preventative removals a public health hazard in the American Journal of Public Health. The American Public Health Association has sided with this argument since 2008, when it formally opposed the preventative removal of wisdom teeth. (The same thing happened with tonsils, which doctors no longer remove just to get rid of the chance of infection later on.)

Some doctors, though, still see preventative oral surgery as being two steps ahead of the problem. If you’re going to need your wisdom teeth out eventually, why not have them removed when you’re younger and are more likely to recover more easily? Some think of removing the wisdom teeth early on as a way to lessen the crowding of other teeth

“You might not have symptoms now, but you can’t assume it’s gonna be that way for the rest of your life,” says Dr. Ray White, an oral surgeon working at University of North Carolina. Rather than let the teeth cause problems later on, many oral surgeons remove them.

But a 2012 Cochrane review of randomized clinical trials found there’s no evidence that removing wisdom teeth will prevent or reduce crowding of other teeth down the line. And a different Cochrane review found that watching and waiting can “may reduce the number of surgical procedures by 60 percent or more.

It’s worth noting that oral surgeons make a good chunk of their paychecks by removing wisdom teeth, so there is a financial incentive involved.

“Are there people gaming the system? Sure. You don’t get paid much for not doing anything,” White says. “But I’d hope we can get past that.”

The American Association of Oral and Maxillofacial surgeons says, “There is no pat answer, cookbook recipe, or flow chart that is universally accepted regarding the decision making process” in these cases. So the question comes down to which side of the fence medical professionals fall on, and what works best for their patients.

There’s a chance that if you opt not to have your wisdom teeth taken out, they might be fine for the rest of your life.

There’s also a chance that they’ll need to come out later. If that’s the case, you can’t always plan for it. Opting to have them removed gives patients time to plan around the procedure, which leaves people out of commission for about three days.

But inconvenience isn’t the only risk. “The risk for complications increases as people get older, and the duration of disability after the operation gets longer as people get older,” says oral surgeon Dr. Thomas Dodson.

In some cases, the extraction can be more painful if you wait, Dodson says. That’s because the tooth is easier to remove if its roots aren’t fully developed.

The common risks related to the surgery include poor wound healing, infection, pain, and uncontrolled bleeding. Nerve injury, in rare cases of wisdom teeth removal, can leave people with permanent numbness around the face and mouth, according to the APHA.

Americans spend an estimated $3 billion a year having 10 million wisdom teeth removed, according to the American Public Health Association. That’s a hefty bill for something we may or may not need. How much it costs depends on how the molars are situated. A simple surgical extraction for a wisdom tooth that’s showing through the gums should run about $230, according to Healthcare Bluebook. If it’s impacted (pushed against another tooth and unable to fully come through the gum), the cost jumps to about $400 per tooth.

Update: Added information about the number of teeth removed.