Wisdom Teeth Overview and Characteristics
- Wisdom teeth are the most posterior molars in each quadrant of the human dentition.
- They typically erupt between the late teens and early twenties.
- Most adults have four wisdom teeth, but it is possible to have none, fewer, or more.
- Wisdom teeth can become impacted if there is not enough space for them to come through normally.
- Impacted wisdom teeth can cause tooth decay and inflammation in the surrounding gum tissues.
- Maxillary (upper) third molars have a triangular crown with a deep central fossa and fused roots.
- Mandibular (lower) third molars are the smallest molar teeth with a rounded rectangular crown and reduced size roots.
- The morphology of wisdom teeth can vary.
- Various notation systems are used in dentistry to identify wisdom teeth.
- The Palmer/Zsigmondy system represents maxillary wisdom teeth with ┘ and └, and mandibular wisdom teeth with ┐ and ┌.
- The FDI notational system assigns numbers (18, 28, 48, 38) to maxillary and mandibular third molars.
- The Universal Numbering System numbers the upper wisdom teeth as 1 and 16, and the lower wisdom teeth as 17 and 32.
- The agenesis (absence) of wisdom teeth varies among populations.
- Aboriginal Tasmanians have practically zero agenesis, while indigenous Mexicans have nearly 100% agenesis.
- The difference in agenesis is related to specific genes.
- The age of eruption for wisdom teeth varies between different populations.
- Wisdom teeth tend to erupt earlier in people with African heritage compared to people of Asian and European heritage.
- Eruption commonly occurs between the ages of 17 and 21, but it can start as early as age 13.
- If wisdom teeth have not erupted by age 25, they are unlikely to erupt spontaneously.
- Root development can continue for up to three years after eruption.

Oral Hygiene Care
- Practice good oral hygiene to prevent wisdom tooth pathologies
- Brush teeth twice daily
- Use interdental cleaning methods like dental floss and interdental brushes
- Prevent plaque build-up in interdental areas
- Maintain regular check-ups to identify any oral health problems

Removal of Impacted Wisdom Teeth
- Controversy among dental community regarding removal of asymptomatic impacted wisdom teeth
- Insufficient scientific evidence to determine if removal is necessary
- Decision depends on clinical expertise and patient preference
- Regular check-ups recommended if tooth is retained
- Need for more long-term studies to reach a conclusive answer

Mandibular Third Molar Surgery Recovery
- Platelet-rich fibrin (PRF) used to heal alveolar socket after removal of mandibular third molar
- PRF improves pain sensations, swelling, and reduces risk of dry socket
- No clear correlation between PRF and recovery of jaw spasms, bone restoration, and soft tissue healing
- Larger studies needed to validate current theories
- PRF only reduces symptoms, not completely preventive

Prognosis and Risks
- About one-third of symptomatic unerupted wisdom teeth are non-functional or non-hygienic
- 30% to 60% of people with asymptomatic impacted wisdom teeth will have extraction within 4 to 12 years
- Regular check-ups recommended to monitor impacted wisdom teeth
- Prognosis depends on individual circumstances
- Diagnosis and treatment decisions should be made on a case-by-case basis
- Temporary and permanent inferior alveolar nerve (IAN) damage is a known complication of impacted lower third molar removal
- Proximity of impacted tooth root to mandibular canal increases risk of IAN damage
- Depth of impaction, surgical technique, and surgeon's experience are contributing risk factors
- Careful consideration needed to avoid IAN damage
- Case-by-case evaluation necessary to minimize risk
- Debate among orthodontic community regarding lower anterior teeth crowding
- No consensus on whether wisdom teeth cause crowding
- Factors contributing to crowding include tooth crown size, primary tooth loss, skeletal growth, malocclusions, age, and gender
- Wisdom teeth alone are not considered a sole cause of crowding
- Recent research suggests multiple factors contribute to lower anterior teeth crowding