Wisdom teeth (sometimes called third molars) - are your last set of teeth to emerge into the mouth. Wisdom teeth are not always present in the mouth or need to be removed. Some individuals have four (two top and two bottom). They usually emerge into the mouth between the years of 18-25. It is advised to get the opinion of a qualified health professional*.

Why do wisdom teeth exist?

Academics have debated this question and provided possible explanations including that human diets and lifestyles have changed citing examples of tooth wear found in skulls and eye witness accounts of indigenous rough eating style. Food is now much more processed being softer and easier to chew. The jaw appears have adapted and become smaller over time. However, our genetics still codes for a bigger jaw and an extra set of teeth. 

Wisdom teeth can become impacted that is the tooth fails to erupt into the mouth due to the lack of space or interference from gum tissue, other teeth or bone. This can lead to inflammation, infection and pain initially, but also encourage pathology to develop (cyst growth). 

When do wisdom teeth cause problems?

Wisdom teeth emerge into the mouth about the age of 18-25 years when most problems start to occur.  

Common problems with wisdom teeth are:

1.    Impaction - wisdom teeth fail to erupt into the mouth due to insufficient space, the interference of gums, other teeth or bone. However, cause of impaction is not always apparent and normal vertical developing wisdom tooth may just stop erupting or change direction over a short period of time. Sometimes, the wisdom teeth partially push through the gum or there is a pathway from the mouth to the wisdom tooth via a gap in the gum behind the last standing tooth in the mouth creating a path for bacteria leading to inflammation and infection (pain). Pathology may also develop.

2.    Crowding - This is very contentious discussion point and many experts disagree over the exact impact of wisdom teeth on crowding of teeth. However, back teeth appear to jostle, tilt and/or under erupt or over erupt to create space for wisdom teeth. This misalignment of teeth can create opportunities for food to become trapped, plaque to build up and decay to start. Increase food retention and plaque accumulation can contribute to periodontal health deterioration and gum disease. 

3.    Discomfort - wisdom teeth that are impacted or misaligned permit food and bacteria to become trapped leading to infection and pain around the wisdom tooth and sometimes contributes to restricted opening of the mouth, difficulty swallowing, facial swelling and narrowing of the airway. If you experience any difficulty breathing, swallowing or opening of the jaw then they should immediate see their nearest emergency department at local hospital as this can be deadly.

4.    Infections - wisdom teeth can be very difficult to clean due their abnormal position leading to bacteria build up around the wisdom teeth area causing gum inflammation and disease with time and infections called pericoronitis. 

5.    Pathology - tumors or cysts can arise from unerupted wisdom teeth. The wisdom teeth while in the jaw have an envelope of gum protecting the developing tooth, which disintegrates on entry into the mouth. This envelope of skin can spontaneously develop into pathology with time and grow to cause a tumor/cyst to develop. 

6.    Decay - impacted or submerged wisdom teeth are prone to food trap age and bacterial growth. Bacteria thrive in the warm protected environment which is hard to clean due to wisdom teeth positioning leading to overgrowth and infection and breakdown of tooth structure (decay). This can lead to the need for more complex dental treatment or premature loss of adult teeth.

7.    Adjacent teeth - wisdom teeth can be lodged against the tooth immediately in front leading to food trap age and decay. In some rare teeth can undergo an autoimmune resorption process leading to nerve exposure and pain. This can lead to premature loss of teeth. 

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