A wisdom tooth or third molar refers to one of the four molars per quadrant of the human dentition. Wisdom teeth generally appear between the ages of 17 and 25. Most adults have four wisdom teeth, but it is possible to have fewer or more, in which case the extras are called supernumerary teeth. Wisdom teeth commonly affect other teeth as they develop, becoming impacted or "coming in sideways." They are often extracted when this occurs.
The formation of wisdom teeth differs by population, ranging from practically zero in Tasmanian Aborigines to nearly 100% in indigenous Mexicans. The difference is related to the PAX9 gene (and perhaps other genes).
Wisdom teeth are vestigial third molars that used to help human ancestors in grinding down plant tissue. The common postulation is that the skulls of human ancestors had larger jaws with more teeth, which were possibly used to help chew down foliage to compensate for a lack of ability to efficiently digest the cellulose that makes up a plant cell wall. As human diets changed, smaller jaws gradually evolved, yet the third molars, or "wisdom teeth", still commonly develop in human mouths.
Wisdom teeth 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 BC). A lack of room to allow the teeth to erupt results in a risk of periodontal disease and caries that increases with age. Only a small minority (less than 2%) of adults age 65 years or older maintain the teeth without caries or periodontal disease and 13% maintain unimpacted wisdom teeth without caries or periodontal disease.
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 (or both) that covers them. The classification structure allows clinicians to estimate the probabilities of impaction, infections and complications associated with wisdom teeth removal. Wisdom teeth are also classified by the presence (or absence) of symptoms and disease.
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:440–441, extraction or coronectomy.
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. The term probably came as a translation of the Latin Latin: dens sapientiae.
This article uses anatomical terminology; for an overview, see anatomical terminology.
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|Wikimedia Commons has media related to Wisdom teeth.|
- National Institute of Clinical Health and Excellence Guideline to Wisdom teeth removal
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