Third molar, commonly known as wisdom tooth, is the third molar in each quadrant of the human dentition, located at the posterior of the dental arch.
Scientific name: ”Dens sapientiae” or ”Dens serotinus”
Starting with the age of 8-10 years on the radiograph can be seen the presence or absence of wisdom tooth buds.
At the age of 12, the crown is formed and at the age of 17-18 years, the average age of an appropriate eruption, the roots are developed. At age of 25 years, 90% of wisdom teeth, with enough space on the dental arch, begin to erupt. In some cases, however, they appear later or not at all. Statistics have shown that 20-25% of the population do not have this tooth’s bud. In general, an adult has four wisdom teeth, one in each quadrant, but there are cases when they can be fewer or more (in this case are called supernumerary teeth).
In the past, wisdom teeth were useful on chewing tough aliments, so our predecessors had more developed jaws and enough space for all the teeth on the arch.
In time, modified diet and consumption of soft aliments, caused the underdevelopment of the jaws, but the normal number of teeth on the arch remained the same. So, considering that the wisdom teeth erupts last, if it has not enough space on the arch, in his attempt to create the needed space, it changes the position of the other teeth already erupted on the arch. Sometimes, arches are not spacious enough for wisdom teeth to erupt, so the molars remain in the bone, meaning that the third molar is impacted. At the same time, he can find a small space and partially erupts, remaining semi-impacted.
Due to lack of space, the third molars, in most cases, can produce pain, infections, damages to other teeth on the arch, or may be asymptomatic, changing the position on the arch of the other present teeth, resulting in rotating, malposition and crowding of the frontal group .
Experts believe that wisdom teeth should be extracted when they are impacted or semi-impacted to avoid the possibility of complications (cysts, tumors, damage of the adjacent teeth, etc.)
Reasons for recommending wisdom tooth’s extraction:
– If the molar shows painful symptoms, if it is infected or decayed, his very posterior position hampers treatment options, the extraction is the recommended treatment
– A semi-erupted molar has a greater risk of infection and cavities over time, so often it is indicated to be extracted
– Impacted wisdom teeth show often very high risk of diseases such as tumors, cysts, erosion of adjacent teeth, so it is better to prevent these diseases by extraction.
– In an orthodontic perspective, if wisdom teeth interfere with the orthodontic treatment plan, preventing the successful completion of it, it is recommended the extraction of the third molar.
If you do decide to preserve an impacted wisdom tooth that is asymptomatic, it’s recommended:
– Periodically radiographic check (every 3-4 years) of the molar’s evolution to detect the possibility of complications listed above.
– Painful symptoms can occur long after the installation of a problem, so at the time of occurrence significant damages already exist and may be irreversible.
