Everything You Need to Know About Wisdom Teeth
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Medically reviewed by Edmund Khoo, DDS
Wisdom teeth, also called third molars, are the four last teeth to develop in the mouth.
Many people associate wisdom teeth with surgery, which has become its own sort of rite-of-passage for many young adults. However, not all wisdom teeth need to be removed.
When Do Wisdom Teeth Come In?
Wisdom teeth don’t form in the mouth until early adolescence. They will begin to show up on dental X-rays once they develop underneath the gums around the ages of 8 to 15. For some people, wisdom teeth never form.
Once wisdom teeth form, they can take several years to grow through the gums. Wisdom teeth usually grow out, or erupt, between the ages of 17 and 21. However, in some cases, wisdom teeth never erupt or only partially break through the gums.
Where Are Wisdom Teeth Located?
Wisdom teeth are located in the very back of the mouth, after the second set of molars. Not everyone will have all four wisdom teeth, but if you do, you will have a wisdom tooth at the end of each side of your lower and upper jaw.
Wisdom teeth first form deep underneath the gums, in the jawbone. As the teeth become longer they’ll appear closer to the surface of the gums. The roots develop and are embedded in the alveolar bone, which lines the top and bottom jaw.
Why Do We Have Wisdom Teeth?
Researchers believe our early human ancestors had larger jaws and more teeth. The extra teeth helped our ancestors more easily eat tough, uncooked foods.
But now that humans can cook and make food softer, jaws have gotten smaller in size. That means many people’s jaws are too small for wisdom teeth to come in correctly.
Complications
Impaction is one of the most common problems involving wisdom teeth. An impacted tooth is a tooth that gets stuck below the gum or bone. The tooth can be either completely or partially impacted. A tooth can become impacted because the jaw is too small for the tooth to fit or because the tooth comes in at twisted angles as it tries to emerge.
Impacted wisdom teeth don’t always hurt or cause problems. However, they can lead to the following complications:
Pericoronitis: This is when the tissue surrounding the impacted wisdom tooth becomes infected and inflamed. This usually causes pain and swelling.
Cavities: If the impacted tooth is angled toward the molar next to it in a way that makes the area between the teeth difficult to clean, the food and other debris trapped there can lead to the formation of cavities.
Periodontitis: Also called gum disease, periodontitis is an infection of the tissue that supports the teeth. Left untreated, periodontitis can eventually lead to alveolar bone disease, a breaking down of the bone that supports and surrounds the bottom of the teeth.
Root resorption: This is a breaking down of the roots of the tooth, and it can happen in either the wisdom tooth itself or the tooth next to it.
Neuropathic pain: In some cases, wisdom teeth can be responsible for pain in the jaw area.
Cysts or tumors: Fluid can gather near the tooth and form a cyst that can become painful. A noncancerous tumor can also form in the area. These situations are both rare.
Dentists, orthodontists, and researchers aren’t in agreement over whether wisdom teeth cause crowding and, in turn, teeth misalignment. Some research says wisdom teeth may influence crowding, but that the relationship is weak. One meta-analysis found erupted wisdom teeth may cause crowding more than impacted ones. Other researchers have determined that wisdom teeth—even impacted ones—have no influence on crowding.
Why Do Wisdom Teeth Get Removed?
Wisdom tooth extractions are one of the most common surgeries young adults undergo. In fact, many adults have had at least one wisdom tooth extracted. Between 2007 and 2016, 50% of privately insured dental patients in the U.S. had at least one wisdom tooth removed.
In recent years, many dentists and patients have been reconsidering how necessary the procedure actually is for so many people.
In 2020, a review of studies found that the current science is insufficient to determine whether healthy, impacted wisdom teeth need to be removed. According to the analysis, the evidence is very low that removing healthy wisdom provides any benefit or prevents future complications.
In some people, wisdom teeth do cause significant issues that require them being surgically extracted.
A dentist or orthodontist may recommend you get your wisdom teeth removed if the teeth:
Have become infected
Are impacting another molar
Are undergoing or causing tooth decay
Are at risk of or causing periodontitis
If your wisdom teeth are impacted but not currently causing any problems in your mouth, talk to an oral healthcare provider about whether you should get them removed. You can also see another dentist or orthodontist for a second opinion. In some cases, impacted wisdom teeth can be treated orthodontically rather than surgically.
Whether impacted teeth need to be removed can depend on their angle. Research shows that impacted wisdom teeth angled toward the neighboring molar have a higher risk of cavities, likely because that area is difficult to clean with a toothbrush or floss. If cavities do form in one or both of these convergent teeth, your dentist might recommend removal of the wisdom tooth and sometimes the neighboring molar.
What Is the Surgery Like?
Some wisdom teeth, such as those that have mostly erupted, can be removed without surgery. If your wisdom teeth have already erupted, your dentist will numb the area with local anesthetic. They may use a tool to loosen the tooth in the socket before pulling it.
In other cases, your dentist will refer you to an oral surgeon for the procedure, especially if the teeth need to be extracted from under the gum. Depending on how many teeth and under what conditions they’re being removed, the surgeon may use local anesthesia or suggest intravenous sedation or general anesthesia. During the surgery, they will cut into the gum and remove the tooth, then close the gum back up with stitches that dissolve.
Aftercare is important with wisdom teeth removal. You’ll want to apply an ice pack to the area to reduce swelling over the first few days. You may also experience pain, which you can treat with over-the-counter pain medicines like Advil (ibuprofen) or Tylenol (acetaminophen). You’ll also be asked to eat soft foods and to avoid smoking or strenuous activity.
Wisdom teeth surgery can lead to complications, including:
Dry sockets: Dry sockets are when the blood clot blocking the area where the tooth was removed becomes dislodged. This can lead to complications like infection and exposed nerves or bone.
Infection: If bacteria and food build up in or around the extraction site, an infection can develop. In rare cases, this can happen weeks or months after the surgery. It’s important to take measures like rinsing your mouth with salt water regularly to prevent an infection from forming.
Dental nerve damage: Depending on the tooth’s positioning and how deep under the gum it is, surgical removal may lead to nerve damage in the mouth area. Symptoms include pain, numbness, or tingling. The symptoms usually resolve after a few weeks.
If you see signs of infection or have any worrying symptoms after your surgery, contact your healthcare provider.
A Quick Review
Wisdom teeth are the third set of molars in your mouth. They are the very last teeth at the end of your upper and lower jaw. It’s possible that not all four wisdom teeth will grow.
Wisdom teeth likely served more of a purpose for our early ancestors by helping them eat uncooked food. Today, people’s jaws are smaller and so wisdom teeth often don’t have enough space to develop properly. This can lead to issues like impaction, pain, and cavities. It is unclear whether wisdom teeth, as they grow in, actually change the alignment of your other teeth.
If your wisdom teeth are causing issues in your mouth, your dentist may recommend you get them removed. If your wisdom teeth are impacted but are not causing any complications, you might not need to have them removed. Instead, your dentist will keep an eye on them for any complications that arise.
You can talk to your dentist about the best course of action when it comes to your wisdom teeth.
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Read the original article on Health.
