Parkview Dental Care - David Bertagna, DDS
The Greek philosopher Aristotle, in his book The History of Animals, observed, "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." He wrote this about 350 years before the birth of Christ (BC). Their eruption has been known to cause dental issues for centuries. The third molars, or 'wisdom teeth', are typically the last teeth to erupt in the human oral cavity.
Wisdom teeth are believed to be teeth that were needed to chew vegetable matter that required more mastication due to the cellulose that makes up the cell wall in all plants. Cellulose is the most abundant organic chemical compound on Earth. Humans are unable to digest cellulose, which acts as a bulking agent, or dietary fiber.
Some anthropologists suggest that the diet of vegetable matter caused more wear of the teeth during adolescence. This ensured that more room was available when the third molars erupted. As human diets changed over time, these teeth were not as necessary to masticate (chew) the foods that became more common, such as meat.
The change in diet could have contributed to a decrease in the space available in the mouth for the third molars to erupt. Wisdom teeth can affect other teeth as they develop, many times resulting in what is called impaction. Wisdom teeth are the most commonly impacted teeth in the human mouth.
The lack of room in the oral cavity for the third molars to erupt, typically results in an increased risk of periodontal disease and dental caries (cavity). Only 13% of individuals at the age of 65 or older maintain unimpacted third molars without cavities or periodontal disease. In other words, 87% of people with unimpacted third molars have some form of dental disease. This implies that impacted wisdom teeth are even more likely to cause problems.
Most dentists suggest removing the third molars as soon as they erupt into the oral cavity. This is especially true if the person has had orthodontic treatment. This is because they may affect the position of the teeth that have been repositioned by the treatment. As wisdom teeth grow, their roots become longer. This may make it more difficult to remove the tooth or make it more likely for complications to occur.
Not all problems related to third molars are painful or visible. Damage can occur without the person being aware of it. Many times decay begins at the site of the impaction on the tooth in front of the wisdom tooth. Only by a radiograph (x-ray) can this type of lesion be detected. Even the most comprehensive oral exam may not be able to visualize decay below the visible gum line.
The relative ease with which the wisdom tooth may be removed depends on several conditions. These include the position of the tooth and the root development. Impacted teeth will require a more involved surgical procedure. Most wisdom teeth extractions are performed in the oral and maxillofacial surgery office under local anesthesia, intravenous sedation or general anesthesia. Although many general dentists are able to extract wisdom teeth according to their ability, most refer impacted teeth to the oral surgeon.
No one can predict when third molar complications will occur, but when they do, the circumstances can be much more painful and the teeth more difficult to treat. It is estimated that 85% of third molars will eventually need to be removed. After 30 years of practicing dentistry, I agree with this thought process.