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Wisdom Teeth: A Comprehensive Guide

Wisdom teeth—those elusive molars at the back of your mouth that seem to appear out of nowhere – usually pose more questions than answers!

Why do we have these “shy but wise” third molars anyway?

When is it necessary to have an oral surgeon extract them?

Why in the world are they called “wisdom” teeth?

These are just some of the questions that the average patient may have, and the board-certified surgeons at Northwest Oral & Maxillofacial Surgery have the answers!

“Wisdom teeth are the last molars (our third set) to come through in the mouth, usually in the late teens or early 20s. They are named "wisdom teeth" because they appear when people are "older and wiser",” explained Dr. Stephen C. Dwyer of Northwest Oral & Maxillofacial Surgery. “Wisdom teeth are a normal part of mouth development. Humans have genetically evolved to have 32 teeth, of which four are third molars. The rough diets of our human ancestors may have necessitated this third set of molars.”

Where Are Wisdom Teeth Located?

Wisdom teeth, also known as third molars, are located at the back of your mouth—one set at the top and another at the bottom – behind the second molars.

They are the last set of molars to emerge or erupt, typically making their appearance in late adolescence or early adulthood (usually between the ages of 17 and 25). Positioned at the end of your dental arches, these molars can be found at the upper and lower corners of your mouth.

Wisdom teeth can erupt "impacted", meaning they are trapped in the jawbone or gum tissue and cannot fully emerge.

Why Do We Have Wisdom Teeth?

Thousands of years ago, our ancestors relied on a diet that included coarse, rough foods. Wisdom teeth were essential for chewing and grinding this diet effectively.

However, as our diets evolved and jaws reduced in size over time, wisdom teeth became less necessary.

In fact, wisdom teeth are thought to have been vestigial organs, meaning they are no longer necessary. Other vestigial organs include the appendix and tonsils.

Today, wisdom teeth often pose challenges due to their potential for misalignment, impaction, and other issues.

How are Wisdom Teeth Different From Our Other Teeth?

Wisdom teeth are different from our other teeth in several ways:

  • They are typically smaller and have a more irregular shape than your other molars.

  • Wisdom teeth may also have multiple roots (most have two to three roots, but some can have four roots), which can make them more difficult to extract. The Cleveland Clinic says “The shape of the roots can vary from person to person. Often, the roots fuse together, giving the appearance of one big, cone-shaped root. Other times, the roots can curl or splay out in different directions."

  • Of course, the main difference is that wisdom teeth are the last set of your teeth to develop and grow in.

What is the History of Wisdom Teeth and How Did They Get That Unique Name?

In the seventeenth century, these teeth were called “teeth of wisdom,” an early form of the current name. The name “wisdom teeth” supposedly came about in the nineteenth century.

However, Aristotle wrote about these teeth in History of Animals, in the fourth century BC. He said, “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.”

The association between the term and modern centuries may have come from the Industrial Revolution of the 1700s to the 1800s, when people began to eat differently with processed foods and molar impaction became a frequent occurrence.

So, wisdom teeth don't relate to wisdom — apart from people generally being wiser when these teeth grow in.

What Happens When Wisdom Teeth Erupt (or Do Not Erupt!)

While some individuals experience a trouble-free eruption of wisdom teeth, others may encounter complications.

When wisdom teeth erupt properly, they can cause several problems, including:

  • Crowding of other teeth.
  • Pain and inflammation of the gums.
  • Damage to other teeth.
  • Jawbone cysts.
  • Infection.

If wisdom teeth do not erupt properly, they can also cause problems, such as:

  • Impacted wisdom teeth can damage the surrounding teeth and jawbone.
  • Impacted wisdom teeth can also lead to infection.

Understanding the Seriousness of Impacted Wisdom Teeth

Impacted third molars or wisdom teeth is something many patients will experience with the American Association of Oral and Maxillofacial Surgeons estimating that 90 percent of people will develop at least one impacted wisdom tooth.

What Is an Impacted Tooth?

When a tooth is unable to fully enter the mouth, it is said to be “impacted.” In general, impacted teeth are unable to break through the gums because there is not enough room.

Impacted wisdom teeth can be a serious situation because if left in the mouth, impacted wisdom teeth may damage neighboring teeth, or become infected.

Bacteria are of particular concern because the third molar area of the mouth is difficult to clean, making it a site that invites the bacteria that leads to gum disease. Oral bacteria may travel from your mouth through the bloodstream, where it may lead to possible systemic infections and illnesses that affect the heart, kidneys, and other organs.

In fact, research has shown that once periodontal disease is established in the third molar areas, the problem is persistent and progressive, but may improve following extraction of the teeth.

In some cases, a fluid-filled cyst or tumor may form around the base of the untreated wisdom tooth. As the cyst grows it may lead to more serious problems as it hollows out the jaw and damages surrounding nerves, teeth, and other structures.

Why Do Patients Have Their Wisdom Teeth Removed?

There are several reasons why patients may have their wisdom teeth removed. The most common reasons include:

  • To prevent problems caused by impacted wisdom teeth just discussed above.
  • To relieve pain and inflammation caused by wisdom teeth.
  • To make room for orthodontic treatment.
  • To prevent cysts or tumors from forming around wisdom teeth.

Symptoms such as pain, swelling, and difficulty chewing may indicate problems with these third molars. Recognizing these signs is crucial for addressing potential issues promptly.

What is the Procedure Like?

Extraction of wisdom teeth is a common dental procedure, often recommended to prevent or alleviate various complications. Extraction is a proactive measure to maintain optimal oral health.

The timing for extraction is typically in late adolescence or early adulthood when these molars emerge.

Extractions are typically performed in a dental office or oral surgery center. Patients are usually given local anesthesia to numb the area around the tooth.

In some cases, general anesthesia may be used to put the patient completely asleep.

The surgeon or dentist will make an incision in the gum tissue and then use forceps or other instruments to remove the tooth. The incision is then closed with sutures.

What is Wisdom Teeth Extraction Recovery Like?

After wisdom teeth removal, patients can expect to experience some pain, swelling, and bleeding.

The pain is usually mild to moderate and can be controlled with over-the-counter pain medication.

Swelling typically peaks 2-3 days after the procedure and then gradually subsides. Bleeding is usually minimal and can be controlled by applying ice packs to the area.

Most patients can return to their normal activities within a few days. However, it is important to avoid strenuous activity and to follow the oral surgeon or dentist's instructions for aftercare.

Caring for Your Wisdom Teeth

Maintaining good oral hygiene is essential for preventing issues with your wisdom teeth. Brush and floss regularly, paying special attention to the back of your mouth.

Regular dental check-ups are crucial for monitoring the development and health of your wisdom teeth. Your dentist can provide personalized advice based on the specific characteristics of your oral anatomy.

Understanding your wisdom teeth empowers you to make informed decisions about your oral health. By incorporating proper care into your routine, you can ensure a healthier, happier smile for years to come.

If you have any concerns or questions about your wisdom teeth, consult Northwest Oral & Maxillofacial Surgery today.




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