The need for extraction of the wisdom tooth is one of the most controversial topics discussed internationally.There are few aspects common to third molar/wisdom tooth which makes them unique and different from rest of the teeth.
It is a tooth with most diverse shape; there is very less chance of seeing two identical wisdom teeth in two individuals. Eruption age 18 to 26 yrs but the possibility of seeing a wisdom teeth in a 30 yr old patient is 75 %, sometimes partially erupted or fully impacted. Cases of impacted wisdom teeth have tremendously increased in past few decades which are believed to be due to change in dietary habits.
When there is wisdom tooth in the mouth
It aids in grinding food, but the other tooth function like phonation, facial symmetry etc are not much influenced by it as they erupt too late. On the other hand, the disturbances it can offer are ample. Since the area is beyond the reach of the toothbrush, it is difficult to clean, so the risk of cavities increases if it is half impacted or fully erupted also. In half erupted cases chances of food lodgement and thereby bacterial growth can lead to swelling in surrounding gum tissue (Pericoronitis). Furthermore, the entry of this late guest, demanding more space, worsens an orthodontically corrected case.
When wisdom tooth is fully impacted
Earlier concept-"No need to fear the enemy who can never appear in front of you" & its true in 20% of cases but the complications offered by the other 80% is much more than if they would have fully erupted.
At the site of impaction there occurs unexplained pain as it exerts pressure on the nearby nerve, cyst or a tumour can form around impacted teeth and they can even damage the adjacent teeth.
However, It is always a combined and discussed the choice of the doctor and the patient to go for surgical removal or to retain it after considering factors like uncontrolled diabetes, bleeding disorders, closely associated vital structures and other medically compromised patients.