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
The third molar, commonly called wisdom tooth, is the most posterior of the three molars in each quadrant of the human dentition. The age at which wisdom teeth come through (erupt) is variable, but this generally occurs between late teens and early twenties. Most adults have four wisdom teeth, one in each of the four quadrants, but it is possible to have none, fewer, or more, in which case the extras are called supernumerary teeth. Wisdom teeth may become stuck (impacted) against other teeth if there is not enough space for them to come through normally. Impacted wisdom teeth are still sometimes removed for orthodontic treatment, believing that they move the other teeth and cause crowding, though this is not held anymore as true.
Wisdom tooth | |
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Wisdom teeth in the human mouth for permanent teeth. There are none in deciduous (children's) teeth. | |
![]() Wisdom teeth | |
Identifiers | |
MeSH | D008964 |
TA98 | A05.1.03.008 |
TA2 | 911 |
FMA | 321612 |
Anatomical terminology |
Impacted wisdom teeth may suffer from tooth decay if oral hygiene becomes more difficult. Wisdom teeth which are partially erupted through the gum may also cause inflammation and infection in the surrounding gum tissues, termed pericoronitis. More conservative treatments, such as operculectomies, may be appropriate for some cases. However, impacted wisdom teeth are commonly extracted to treat or prevent these problems. Some sources oppose the prophylactic removal of disease-free impacted wisdom teeth, including the National Institute for Health and Care Excellence in the UK.
From wisdom + tooth, calque of Latin dēns sapientiae, which is itself a calque of Ancient Greek σωφρονιστῆρες (sōphronistêres, “prudent or self-controlled ones (i.e. teeth)”), because they arrive approximately when one has reached the age of prudence or wisdom. Compare also German Weisheitszahn (“wisdom
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