Space travel leaves no room for medical uncertainty. When astronauts embark on long-duration missions—often months or years away from Earth—even minor health problems can escalate into serious emergencies. That’s why space agencies take an unusually proactive medical approach, including prophylactic removal of wisdom teeth and sometimes the appendix, even when they’re not causing immediate problems on Earth.
Here’s why astronauts are advised to do it:
Even Shubhanshu Shukla, India’s first astronaut to reach the International Space Station, had to have two of his wisdom teeth extracted. Speaking at IIT Bombay, the IAF officer shared, “Your dental health is extremely important. You are medically trained to take care of any emergency or any situation that occurs…But if there’s one thing you can’t do, it’s dental surgery. So they make sure you don’t have any problems before you go.”
“If you want to be an astronaut, you have to give up your wisdom,” Shukla added.
“Both wisdom teeth and the appendix are known for their unpredictability,” says Dr Hamid Raihan, Sr. Consultant & Head – Dental Services, Asian Hospital. “They may not cause problems for years, but when they do, the onset is often sudden and requires urgent care — which is simply not available during space missions.”
Wisdom teeth are particularly prone to infections due to trapped food particles and bacterial build-up, and appendicitis can strike without warning. The larger the mission, the greater the risk of such an acute episode, explains Dr. Reichan.
“Space medicine follows a philosophy of eliminating risk rather than treating,” he adds. “By preemptively removing potential sources of contamination, astronauts are medically optimized to minimize emergencies that could threaten the health of both and the success of the mission”.
How could conditions like appendicitis or impacted wisdom teeth become more dangerous in microgravity and space environments?
Representative image (Photo: Freepik)
Microgravity triggers significant physiological changes in the human body, which can worsen dental and abdominal conditions, explains Dr. Raihan. “In space, astronauts often experience facial congestion and altered saliva flow, which can exacerbate dental inflammation and discomfort. Combined with bone loss and a weakened immune response, the risk of infection increases while healing is slowed.”
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Appendicitis presents additional challenges in microgravity. The inflammation may not progress in a typical way, making early symptoms more difficult to recognize. Changes in pain perception and limited diagnostic tools increase the risk of late detection and rupture.
“An infection that can remain localized on Earth can spread more quickly in space,” adds Dr. Raihan. “Without early intervention, a manageable condition can quickly become life-threatening.”
What medical limitations in space make routine surgical procedures nearly impossible during a mission?
“Performing invasive procedures in microgravity is extremely difficult,” says Dr. Raihan. “Maintaining sterility, controlling bleeding, and ensuring precise surgical maneuvers are all significant hurdles.”
While astronauts receive basic medical training, complex surgeries require specialized skills, advanced imaging, anesthesia and post-operative care — resources that are severely limited in space, he adds. “Pain management options are limited and sore healing is slower due to microgravity-caused physiological changes.
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“In many cases, evacuation back to Earth can take days or even weeks,” notes Dr. Reichan. “Given these limitations, preventive care remains the safest and most reliable medical strategy for space travel.”
DISCLAIMER: This article is based on information from the public sector and/or experts we spoke to. Always consult your healthcare professional before starting any routine.
