1. Does Everyone Have Wisdom Teeth Removed

Not everyone gets their wisdom teeth. In fact, 35% of people do not develop wisdom teeth. People who do get their wisdom teeth may need to have them removed to avoid certain dental problems, such as swelling and overcrowding.

A wisdom tooth or third molar is one of the three molars per quadrant of the human dentition. It is the most posterior of the three. The age at which wisdom teeth come through (erupt) is variable,^[1] but generally occurs between late teens and early twenties.^[2] Most adults have four wisdom teeth, one in each of the four quadrants, but it is possible to have none, fewer, or more, in which case the extras are called supernumerary teeth. Wisdom teeth may get stuck (impacted) against other teeth if there is not enough space for them to come through normally. While this does not cause movement of other teeth,^[3] it can cause tooth decay if the impaction makes oral hygiene difficult. Wisdom teeth which are partially erupted through the gum may also cause inflammation and infection in the surrounding gum tissues, termed pericoronitis. Wisdom teeth are often extracted when or even before these problems occur. However, some, including the National Institute for Health and Care Excellence in the UK, recommend against the prophylactic extraction of disease-free impacted wisdom teeth.^[3][4]

• 1Structure

Structure

Variation

Agenesis of wisdom teeth differs by population, ranging from practically zero in Aboriginal Tasmanians to nearly 100% in indigenous Mexicans^[5] (see research paper with world map showing prevalence). The difference is related to the PAX9, and MSX1 gene (and perhaps other genes).^[6][7][8][9]

Age of eruption

There is significant variation between the reported age of eruption of wisdom teeth between different populations.^[10] For example, wisdom teeth tend to erupt earlier in black people compared to Asian and white people.^[10]

Generally wisdom teeth are stated as erupting most commonly between age 17 and 21.^[1] Eruption may start as early as age 13 in some groups.^[10] Sometimes they can erupt up to age 25.^[11] If they have not erupted by age 25, oral surgeons generally consider that the tooth will not erupt spontaneously by itself.^[2]

Function

Wisdom teeth are vestigial third molars that helped human ancestors to grind plant tissue. It is thought that the skulls of human ancestors had larger jaws with more teeth, which possibly helped to chew foliage to compensate for a lack of ability to efficiently digest the cellulose that makes up a plant cell wall.^[12] After the advent of agriculture over 10,000 years ago, soft human diets became the norm, including carbohydrate and high energy foods. Such diets typically result in jaws growing with less forward growth than our paleolithic ancestors and not enough room for the wisdom teeth.^[13]

Clinical significance

Does Everyone Have Wisdom Teeth Removed

Wisdom teeth (often notated clinically as M3 for third molar) have long been identified as a source of problems and continue to be the most commonly impacted teeth in the human mouth. The oldest known impacted wisdom tooth belonged to a European woman of the Magdalenian period (18,000–10,000 BCE).^[14] A lack of room to allow the teeth to erupt results in a risk of periodontal disease and dental cavities that increases with age.^[15] Less than 2% of adults age 65 years or older maintain the teeth without cavities or periodontal disease and 13% maintain unimpacted wisdom teeth without cavities or periodontal disease.^[16]

Impacted wisdom teeth are classified by the direction and depth of impaction, the amount of available space for tooth eruption and the amount soft tissue or bone that covers them. The classification structure allows clinicians to estimate the probabilities of impaction, infections and complications associated with wisdom teeth removal.^[15] Wisdom teeth are also classified by the presence of symptoms and disease.^[17]

Treatment of an erupted wisdom tooth is the same as any other tooth in the mouth. If impacted, treatment can be localized to the infected tissue overlying the impaction,^{[18]:440–441} extraction^[19] or coronectomy.^[20]

History

Although formally known as third molars, the common name is wisdom teeth because they appear so late – much later than the other teeth, at an age where people are presumably 'wiser' than as a child, when the other teeth erupt.^[21] The term probably came as a translation of the Latindens sapientiae. Their eruption has been known to cause dental issues for millennia; it was noted at least as far back as Aristotle:

The last teeth to come in man are molars called 'wisdom-teeth', which come at the age of twenty years, in the case of both sexes. Cases have been known in women upwards of eighty years old where at the very close of life the wisdom-teeth have come up, causing great pain in their coming; and cases have been known of the like phenomenon in men too. This happens, when it does happen, in the case of people where the wisdom-teeth have not come up in early years.

Nonetheless, molar impaction was relatively rare prior to the modern era. With the Industrial Revolution, the affliction became ten times more common, owing to the new prevalence of soft, processed, and sugary foods.^[23]

See also

References

1. ^ ^abMcCoy, JM (September 2012). 'Complications of retention: pathology associated with retained third molars'. Atlas of the oral and maxillofacial surgery clinics of North America. 20 (2): 177–95. doi:10.1016/j.cxom.2012.06.002. PMID23021395.
2. ^ ^abSwift, JQ; Nelson, WJ (September 2012). 'The nature of third molars: are third molars different than other teeth?'. Atlas of the oral and maxillofacial surgery clinics of North America. 20 (2): 159–62. doi:10.1016/j.cxom.2012.07.003. PMID23021392.
3. ^ ^abFriedman, JW (September 2007). 'The prophylactic extraction of third molars: a public health hazard'. American journal of public health. 97 (9): 1554–9. doi:10.2105/AJPH.2006.100271. PMC1963310. PMID17666691.
4. ^Guidance on the Extraction of Wisdom Teeth. National Institute of Clinical Excellence. 27 March 2000. ISBN9781473131484.
5. ^Rozkovcová, E.; Marková, M.; Dolejší, J. (1999). 'Studies on agenesis of third molars amongst populations of different origin'. Sborník lékařský. 100 (2): 71–84. PMID11220165.
6. ^Pereira, Tiago V.; Salzano, Francisco M.; Mostowska, Adrianna; Trzeciak, Wieslaw H.; Ruiz-Linares, Andrés; Chies, José A. B.; Saavedra, Carmen; Nagamachi, Cleusa; et al. (2006). 'Natural selection and molecular evolution in primate PAX9 gene, a major determinant of tooth development'. Proceedings of the National Academy of Sciences. 103 (15): 5676–81. Bibcode:2006PNAS.103.5676P. doi:10.1073/pnas.0509562103. JSTOR30050159. PMC1458632. PMID16585527.
7. ^Bonczek, O; Balcar, VJ; Šerý, O (2017). 'PAX9 gene mutations and tooth agenesis: A review'. Clin Genet. 92 (5): 467–476. doi:10.1111/cge.12986. PMID28155232.
8. ^Lidral, AC; Reising, BC (April 2002). 'The role of MSX1 in human tooth agenesis'. J. Dent. Res. 81 (4): 274–8. doi:10.1177/154405910208100410. PMC2731714. PMID12097313.
9. ^Tallón-Walton, V; Manzanares-Céspedes, MC; Carvalho-Lobato, P; Valdivia-Gandur, I; Arte, S; Nieminen, P (2014). 'Exclusion of PAX9 and MSX1 mutation in six families affected by tooth agenesis. A genetic study and literature review'. Med Oral Patol Oral Cir Bucal. 19 (3): e248–54. PMC4048113. PMID24316698.
10. ^ ^abcTsokos, Michael (2008). Forensic Pathology Reviews 5. Springer Science & Business Media. p. 281. ISBN9781597451109.
11. ^'Wisdom Teeth'. American Association of Oral and Maxillofacial Surgeons. Archived from the original on July 28, 2010. Retrieved 2010-09-28. This generally occurs between the ages of 16 and 25
12. ^Cooper, Rachele (February 5, 2007). 'Why Do We Have Wisdom Teeth?'. Scienceline.org. Archived from the original on 2016-05-03.
13. ^von Cramon-Taubadel, Noreen (2011-12-06). 'Global human mandibular variation reflects differences in agricultural and hunter-gatherer subsistence strategies'. Proceedings of the National Academy of Sciences of the United States of America. 108 (49): 19546–19551. Bibcode:2011PNAS.10819546V. doi:10.1073/pnas.1113050108. ISSN0027-8424. PMC3241821. PMID22106280.
14. ^'Magdalenian Girl is a woman and therefore has oldest recorded case of impacted wisdom teeth' (Press release). Field Museum of Natural History. March 7, 2006. Retrieved February 15, 2013.
15. ^ ^abJuodzbalys, Gintaras; Daugela, Povilas (Apr–Jun 2013). 'Mandibular Third Molar Impaction: Review of Literature and a Proposal of a Classification (review)'. J Oral Maxillofac Res. 4 (2): e1. doi:10.5037/jomr.2013.4201. PMC3886113. PMID24422029.
16. ^Marciani RD (2012). 'Is there pathology associated with asymptomatic third molars (review)'. J Oral Maxillofac Surg. 70 (Suppl 1): 15–19. doi:10.1016/j.joms.2012.04.025.
17. ^Dodson TB (Sep 2012). 'The management of the asymptomatic, disease-free wisdom tooth: removal versus retention. (review)'. Atlas Oral Maxillofac Surg Clin North Am. 20 (2): 169–76. doi:10.1016/j.cxom.2012.06.005. PMID23021394.
18. ^Newman MG, Takei HH, Klokkevold PR, Carranza FA (2012). Carranza's Clinical Periodontology. Elsevier Saunders. ISBN978-1-4377-0416-7.
19. ^Pogrel MA (2012). 'What are the Risks of Operative Intervention (review)'. J Oral Maxillofac Surg. 70 (Suppl 1): 33–36.
20. ^Ghaeminia H (2013). 'Coronectomy may be a way of managing impacted third molars (systematic review)'. Evid Based Dent. 14 (2): 57–8. doi:10.1038/sj.ebd.6400939. PMID23792405.
21. ^'Wisdom tooth'. Oxford English Dictionary. Oxford: Oxford University Press. 1989. ISBN0-19-861186-2.
22. ^Aristotle (2015). The History of Animals. Translated by D'Arcy Wentworth Thompson. Aeterna Press. p. 49.
23. ^'What teeth reveal about the lives of modern humans'. What teeth reveal about the lives of modern humans. Retrieved 2018-10-22.

External links

• Wisdom tooth extraction WebMD article

• Eruption of wisdom teeth is not continuous, so every three to five months you may experience the same pain for a few days. The wisdom tooth eruption influences the bone position of the other teeth so you may find that your teeth begin to shift.
• If the wisdom teeth are not able to erupt normally, they may become trapped or impacted within your jawbone. This increases the risk of infection (see below).
• The pain from erupting wisdom teeth can get worse at night if you have a habit of clenching your jaw and/or grinding your molars.
• Chewing gum may also aggravate the pain caused by wisdom teeth.