Having wisdom teeth is nothing new, but removing them is. Our ancestors didn’t have to undergo this procedure, so why then is my dentist telling me I need Summit Dental châtelaine to?

Wisdom teeth, also known as third molars, typically make their debut in early adulthood, usually between the ages of 17 and 25. In a fortunate minority, these teeth emerge in a perfectly normal position, providing extra molars for chewing and grinding foods. However, for the majority, these latecomers often bring more trouble than wisdom. Wisdom teeth removal has become a common dental procedure, but have you ever wondered why these teeth have become such a problem for many? The answer lies in the evolutionary mismatch between our diet and our Summit Dental chatelaine genes.

The most common reason for impacted third molars is a discrepency between the size of the jaw and the space needed for the teeth.

Statistics :

  • 5-33% of the population will have an agenesis of the third molars. Meaning they are born with one or more missing third molars.
  • 17-32% of the population will have non-erupting (impacted) third molars.
    • Of impacted third molars, 83% will be partially impacted, while 17% will be totally impacted.

The Evolutionary Mismatch:

Our ancestors had a diet that included coarse, unprocessed foods that required substantial chewing and grinding. This constant use of their teeth served as a sort of natural dental maintenance, keeping their jaws and teeth in harmony. As a result, their jaws were larger, accommodating all the teeth comfortably. But, as time went on, our diets evolved into softer and more refined options, thanks to cooking and food processing techniques. This shift led to a significant change in the size and function of our jaws.

While our diet became softer, our genes remained largely unchanged. In fact, our ancestors used their teeth not only for eating but also as tools. This additional wear and tear meant that their teeth were often smaller due to natural attrition. In contrast, modern humans often have larger teeth, including the wisdom teeth, due to reduced wear.

One of the primary reasons wisdom teeth often pose problems is their late arrival on the scene. They are the last set of molars to emerge, and by the time they do, there’s often limited space left in the mouth. As a result, they frequently become misaligned, causing pain, crowding, and various other issues.

It’s important to note that misalignment isn’t limited to wisdom teeth; many people experience orthodontic issues that require intervention. However, wisdom teeth tend to be the most troublesome latecomers in the dental world.

A machine with noodles being made

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When wisdom teeth do manage to partially emerge or become “semi-impacted,” they can become a breeding ground for problems. These partially emerged teeth are challenging to clean properly, making them prone to infection and decay. They can also push against neighboring teeth, causing discomfort, pain, and potential misalignment of other teeth. In more severe cases, they can even lead to the formation of cysts and abscesses, necessitating immediate intervention.

Is not having my wisdom teeth removed dangerous? 

Remember that for many patients, removing your wisdom teeth will not (or should not) be recommended, so of course no, there is no risk in leaving them in place, in these cases. Among patients for whom dentists recommend removing wisdom teeth, in many cases removal is a prophylactic procedure. That means it is recommended to prevent something from happening in the future. This is based on a simple calculation. The risk of a negative event occurring in the future because of the presence of your wisdom teeth vs. the risk of removing them. This is important to consider, because removing your wisdom teeth is a medical procedure, and no medical procedure is without risk. It is important to understand you specific risk profile prior to treatment, and your doctor should always inform you of any specific risks that may concern you. In general however, removal of wisdom teeth has become a very common and relatively low risk procedure for the average patient. 

Let consider two different scenarios

You probably don’t need years of dental school to see the difference between the wisdom teeth in the following radiographs. The two images showcase contrasting conditions of wisdom teeth. 

A close-up of teeth

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Wisdom tooth in poor alignement with the adjacent tooth

On the left, we see a radiograph of a wisdom tooth that is still erupting. If all goes according to plan, we can say this this is a well-aligned wisdom tooth, situated comfortably in the jaw. If all other things are considered ok, then this a tooth that we may prefer to follow up on, rather than treat right away. In contrast, the image on the right depicts a mesially aligned wisdom tooth that is nearly horizontal, posing a significant risk. This misalignment is causing impingement on the adjacent second molar, potentially leading to complications and discomfort. The difference between these images highlights the importance of proper wisdom tooth positioning in maintaining oral health.

Does removing (or not) my wisdom teeth affect the alignment of my teeth ?

For most people, no. In certain cases, wisdom teeth can push on adjacent teeth, but the forces are usually localised and do not affect the position of your other teeth. This is however a very common myth. Definitive conclusions on the role of the third molars in the development of anterior tooth crowding cannot be drawn as a high risk of bias has been found in many trials, and the outcomes were not consistent. However, most of the studies do not support a cause-and-effect relationship; therefore, third molar extraction to prevent anterior tooth crowding or postorthodontic relapse is not justified.

Youn can check out this scientific publication for more details !

Zawawi KH, Melis M. The role of mandibular third molars on lower anterior teeth crowding and relapse after orthodontic treatment: a systematic review. ScientificWorldJournal. 2014;2014:615429. doi: 10.1155/2014/615429. Epub 2014 Apr 30. PMID: 24883415; PMCID: PMC4032723.

https://doi.org/10.1155/2014/615429

So why does my orthodontist reccomend removing them then?

While leaving wisdom teeth in place does not cause crowding or shifting of your teeth, in some orthodontic cases, removing wisdom teeth can be useful to create additional space for teeth to move into their correct positions more effectively. It can aid in achieving the desired orthodontic outcomes. 

A Personal Decision:

Wisdom teeth removal is not a one-size-fits-all procedure. It’s a decision that should be made with careful consideration, taking into account an individual’s unique dental and medical history. It is ALWAYS the patient’s choice whether to have their wisdom teeth removed. A dentist should advise you to make the right decision, but you should never feel pressured to undergo a medical procedure, no matter how routine it has become.

Image of person using a dental radiograph on an ipad to explain the treatment for wisdom teeth extraction. radiologie Dentaire pour dents de sagesse

Consulting Your Dentist:

If you’re facing the question of whether or not to remove your wisdom teeth, it’s crucial to consult with a professional. A dentist can assess your specific risk profile, the position of your wisdom teeth, and any existing issues to help you make an informed decision.

If you remain unsure, never hesitate to call us at Summit Dental to ask for a second opinion. If it was us that advised you in the first place, but you remain unsure, don’t hesitate to send us an email of call the office to ask for clarification.

At Summit Dental, we believe in a conservative approach, advocating for wisdom teeth removal on a case-by-case basis. We understand that each patient’s situation is unique, and our goal is to provide the best care tailored to your needs.

The saga of wisdom teeth is a fascinating tale of evolution, dietary changes, and individual variability. While many people will undergo wisdom teeth removal, it’s essential to remember that it’s a personal choice, based on your specific dental health and risk profile. Consulting with your dentist is the first step to making an informed decision about the fate of your wisdom teeth. At Summit Dental, we’re here to help you navigate this important dental decision, ensuring the best care for your unique situation.