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Wisdom tooth
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{{About|the anatomy of wisdom teeth|wisdom teeth removal surgery|Impacted wisdom teeth|the upcoming Hong Kong film|Wisdom Tooth (film)}}







factoids
A wisdom tooth or third molar is one of the three molars per quadrant of the human dentition. It is the most posterior of the three. The age at which wisdom teeth come through (erupt) is variable,JOURNAL, McCoy, JM, Complications of retention: pathology associated with retained third molars., Atlas of the oral and maxillofacial surgery clinics of North America, September 2012, 20, 2, 177-95, 10.1016/j.cxom.2012.06.002, 23021395,weblink but 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 commonly affect other teeth as they develop, becoming impacted. They are often extracted when or even before this occurs.

Structure

Variation

Agenesis of wisdom teeth differs by population, ranging from practically zero in Aboriginal Tasmanians to nearly 100% in indigenous MexicansJOURNAL, 11220165, 1999, Rozkovcová, E., Marková, M., Dolejší, J., Studies on agenesis of third molars amongst populations of different origin, 100, 2, 71–84, Sborník lékařský, (see research paper with world map showing prevalence). The difference is related to the PAX9, and MSX1 gene (and perhaps other genes).JOURNAL, 10.1073/pnas.0509562103, Natural selection and molecular evolution in primate PAX9 gene, a major determinant of tooth development, 2006, Pereira, Tiago V., Francisco M., Salzano, Adrianna, Mostowska, Wieslaw H., Trzeciak, Andrés, Ruiz-Linares, José A. B., Chies, Carmen, Saavedra, Cleusa, Nagamachi, Ana M., Hill, K., Castro-De-Guerra, D., Silva-Junior, W. A., Bortolini, M.-C., Hurtado, Proceedings of the National Academy of Sciences, 103, 15, 5676–81, 16585527, 2006PNAS..103.5676P, 30050159, 1458632, 8, JOURNAL, 28155232, 10.1111/cge.12986, 92, 5, PAX9 gene mutations and tooth agenesis: A review, 2017, Clin Genet, 467–476, Bonczek, O, Balcar, VJ, Šerý, O, JOURNAL, 2731714, 12097313, 81, 4, The role of MSX1 in human tooth agenesis, April 2002, J. Dent. Res., 274–8, Lidral, AC, Reising, BC, 10.1177/154405910208100410, JOURNAL, 4048113, 24316698, 19, 3, Exclusion of PAX9 and MSX1 mutation in six families affected by tooth agenesis. A genetic study and literature review, 2014, Med Oral Patol Oral Cir Bucal, e248-54, Tallón-Walton, V, Manzanares-Céspedes, MC, Carvalho-Lobato, P, Valdivia-Gandur, I, Arte, S, Nieminen, P,

Age of eruption

There is significant variation between the reported age of eruption of wisdom teeth between different populations.BOOK, Tsokos, Michael, Forensic Pathology Reviews 5, 2008, Springer Science & Business Media, 9781597451109, 281,weblink en, For example, wisdom teeth tend to erupt earlier in blacks compared to asians and whites.Generally wisdom teeth are stated as erupting most commonly between age 17 and 21. Eruption may start as early as age 13 in some groups. Sometimes they can erupt up to age 25.WEB,weblink Wisdom Teeth, American Association of Oral and Maxillofacial Surgeons, 2010-09-28, This generally occurs between the ages of 16 and 25, yes,weblink" title="web.archive.org/web/20100728221912weblink">weblink July 28, 2010, If they have not erupted by age 25, oral surgeons generally consider that the tooth will not erupt spontaneously by itself.JOURNAL, Swift, JQ, Nelson, WJ, The nature of third molars: are third molars different than other teeth?, Atlas of the oral and maxillofacial surgery clinics of North America,weblink September 2012, 20, 2, 159-62, 10.1016/j.cxom.2012.07.003, 23021392,

Function

{{See also|Human vestigiality}}Wisdom teeth are vestigial third molars that helped human ancestors to grind plant tissue. It is thought that the skulls of human ancestors had larger jaws with more teeth, which possibly helped to chew foliage to compensate for a lack of ability to efficiently digest the cellulose that makes up a plant cell wall.WEB, Cooper, Rachele, Why Do We Have Wisdom Teeth?,weblink Scienceline.org,weblink" title="web.archive.org/web/20160503040129weblink">weblink 2016-05-03, February 5, 2007, no, After the advent of agriculture over 10,000 years ago, soft human diets became the norm, including carbohydrate and high energy foods. Such diets typically result in jaws growing with less forward growth than our paleolithic ancestors and not enough room for the wisdom teeth.JOURNAL, von Cramon-Taubadel, Noreen, 2011-12-06, Global human mandibular variation reflects differences in agricultural and hunter-gatherer subsistence strategies, Proceedings of the National Academy of Sciences of the United States of America, 108, 49, 19546–19551, 10.1073/pnas.1113050108, 0027-8424, 3241821, 22106280, 2011PNAS..10819546V,

Clinical significance

{{See also|Dental extraction|Impacted wisdom teeth}}
missing image!
- 38 pericoronitis with pus.jpg -
A wisdom tooth protrudes outwards from the gumline with inflamed tissue at the back (pericoronitis; green arrow)
Wisdom teeth (often notated clinically as M3 for third molar) have long been identified as a source of problems and continue to be the most commonly impacted teeth in the human mouth. The oldest known impacted wisdom tooth belonged to a European woman of the Magdalenian period (18,000–10,000 BCE).PRESS RELEASE, Magdalenian Girl is a woman and therefore has oldest recorded case of impacted wisdom teeth, Field Museum of Natural History, March 7, 2006,weblink February 15, 2013, A lack of room to allow the teeth to erupt results in a risk of periodontal disease and dental cavities that increases with age.JOURNAL, 3886113, Mandibular Third Molar Impaction: Review of Literature and a Proposal of a Classification (review), J Oral Maxillofac Res, Apr–Jun 2013, 4, 2, e1, 10.5037/jomr.2013.4201, 24422029, Juodzbalys, Gintaras, Daugela, Povilas, Less than 2% of adults age 65 years or older maintain the teeth without cavities or periodontal disease and 13% maintain unimpacted wisdom teeth without cavities or periodontal disease.JOURNAL, Is there pathology associated with asymptomatic third molars (review), Marciani RD, J Oral Maxillofac Surg, 2012, 70, Suppl 1, 15–19, 10.1016/j.joms.2012.04.025, File:Lower mandibular third molar impaction pericoronitis diagram.jpg|thumbnail|left|Some problems which may or may not occur with third molars: A Mesio-impacted, partially erupted mandibular third molar, B Dental caries and periodontal defects associated with both the third and second molars, caused by food packing and poor access to oral hygiene methods, C Inflamed operculum covering partially erupted lower third molar, with accumulation of food debris and bacteria underneath, D The upper third molar has over-erupted due to lack of opposing tooth contact, and may start to traumatically occlude into the operculum over the lower third molar. Unopposed teeth are usually sharp because they have not been blunted by another tooth.]]Impacted wisdom teeth are classified by the direction and depth of impaction, the amount of available space for tooth eruption and the amount soft tissue or bone that covers them. The classification structure allows clinicians to estimate the probabilities of impaction, infections and complications associated with wisdom teeth removal. Wisdom teeth are also classified by the presence of symptoms and disease.JOURNAL, The management of the asymptomatic, disease-free wisdom tooth: removal versus retention. (review), Dodson TB, Atlas Oral Maxillofac Surg Clin North Am, Sep 2012, 20, 2, 169–76, 10.1016/j.cxom.2012.06.005, 23021394, Treatment of an erupted wisdom tooth is the same as any other tooth in the mouth. If impacted, treatment can be localized to the infected tissue overlying the impaction,BOOK, Carranza's Clinical Periodontology, Elsevier Saunders, Newman MG, Takei HH, Klokkevold PR, Carranza FA, 2012, 978-1-4377-0416-7, {{rp|440–441}} extractionJOURNAL, What are the Risks of Operative Intervention (review), Pogrel MA, J Oral Maxillofac Surg, 2012, 70, Suppl 1, 33–36, or coronectomy.JOURNAL, Coronectomy may be a way of managing impacted third molars (systematic review), Ghaeminia H, Evid Based Dent, 2013, 14, 2, 57–8., 10.1038/sj.ebd.6400939, 23792405,
missing image!
- Impacted wisdom teeth.jpg -
The upper left (picture right) and upper right (picture left) wisdom teeth are distoangularly impacted. The lower left wisdom tooth is horizontally impacted. The lower right wisdom tooth is vertically impacted (unidentifiable in orthopantomogram).

History

Although formally known as third molars, the common name is wisdom teeth because they appear so late – much later than the other teeth, at an age where people are presumably "wiser" than as a child, when the other teeth erupt.ENCYCLOPEDIA, 1989, Wisdom tooth, Oxford English Dictionary, Oxford University Press, Oxford, 0-19-861186-2, The term probably came as a translation of the Latin dens sapientiae. Their eruption has been known to cause dental issues for millennia; it was noted at least as far back as Aristotle:}}Nonetheless, molar impaction was relatively rare prior to the modern era. With the Industrial Revolution, the affliction became ten times more common, owing to the new prevalence of soft, processed, and sugary foods.NEWS,weblink What teeth reveal about the lives of modern humans, What teeth reveal about the lives of modern humans, 2018-10-22, en-us, {{clear}}

See also

{{Anatomy-terms}}

References

{{Reflist|30em}}

External links

{{Commons category|Wisdom teeth}} {{Tooth anatomy}}{{Authority control}}

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