Your wisdom teeth came out too late!! How often have you heard someone quip that? What are wisdom teeth and why are they called by this strange name? Wisdom teeth or third molars (wisdom molars) are the teeth farthest away in the dental arches and they are usually the last ones to erupt if they ever come out! 

There are four wisdom molars, 2 in the upper jaw (one on each side) and 2 in the lower jaw (one on each side). For their eruption to occur normally, there must be sufficient growth at the back of the jaws to accommodate these teeth. In most people, all the wisdom teeth (4) fail to erupt completely. 

The growth of the lower jaw occurs mostly at the back and this growth is essential to allow the eruption of the third molars. If growth is inadequate, wisdom teeth remain impacted (unerupted). It is very rare to see someone with the maximum possible of 32 teeth in the mouth (including wisdom teeth) that are optimally aligned and functional.

How Was The Name Wisdom Teeth Given to The 3rd Molars?

The 3rd molars usually erupt when an individual has crossed adolescence and becomes a young adult between the age of 18 to 25 years. Due to the age at which they erupt, these teeth have been called the wisdom molars or wisdom teeth. The term “wisdom teeth” is a misnomer and their eruption is not associated with wisdom. 

In our ancestors, these wisdom molars were functional as the size of the dental arches or jawbones were bigger. With evolution, the sizes of the jawbones have diminished resulting in impacted (unerupted), incompletely erupted, or misaligned wisdom molars. 

Thus, the wisdom molars do not participate in the chewing or masticatory function as the other teeth do and are vestigial organs like the appendix. 

What Are Some Reasons For Removing Wisdom Molars?

Wisdom molars may be removed due to:

  • Symptoms such as pain, infection, and tooth decay.

  • Difficulty in cleaning the wisdom molars.  

  • Severe malpositioning of the wisdom molars. 

  • The higher risk of infection and decay it presents in the long term. 

  • Prevent damage to the adjacent 2nd molar (resorption).

  • Prevent the development of pathologies such as cysts or tumours.

What Are Some Reasons For Retaining a Wisdom Molar?

There is no need to remove the wisdom molars:

  • If the tooth is well-positioned, fully erupted, and has an antagonist (opposing tooth in the opposing arch). 

  • If the gum flap covering the tooth has been removed and the tooth is maintainable by regular brushing.

  • When the teeth ahead of them in the arch are missing. In such cases, a fixed artificial tooth prosthesis has to be placed. 

How to Prevent Wisdom Tooth Problems? 

Wisdom teeth problems are inevitable and cannot be completely prevented. However, the problems can be minimised by predicting their eruption using a panoramic radiograph and evaluating certain factors, such as the size of the teeth, the formation of their roots, the direction of the eruption, the available space, and the jaw bone. 

How Are Wisdom Teeth Removed?

It is often believed that wisdom tooth removal is very painful and leads to a lot of swelling. Wisdom teeth are surrounded by dense bone and hence pose a difficulty during removal as opposed to other teeth. Also, their closeness to the mandibular canal (associated with the lower jawbone) may lead to certain complications. Hence, wisdom molar removal is performed by trained oral surgeons. 

Routinely, a minor surgical procedure is required to remove semi-impacted and impacted 3rd molars. The dense bone surrounding the 3rd molars is slightly trimmed and the tooth may be sectioned and removed in 2-3 separate parts to conserve surrounding bone and prevent nerve damage. Some swelling does occur post removal, but effective painkillers are available to tackle it. 

To conclude, it is not always wise to retain wisdom teeth and the removal of these teeth will not affect your wisdom. 

Disclaimer: This article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.