Why do some people keep their wisdom teeth while others need them removed?
Why do some people keep their wisdom teeth while others need them removed?
Some people can keep their wisdom teeth if they have enough jaw space, the teeth grow in properly aligned, and they can keep them clean. Most people need them removed because modern human jaws are often too small to accommodate these extra molars. I’m Dr. Emily, principal dentist at Picasso Dental Clinic, where I’ve been performing wisdom tooth extractions for over 15 years. Throughout my career treating more than 50,000 patients from around the world, I’ve evaluated countless wisdom teeth and helped patients understand when removal is necessary. Let me explain why wisdom teeth cause problems for some people but not others.
The Evolutionary Reason for Wisdom Teeth
Wisdom teeth are leftovers from our ancient ancestors who needed extra molars for their diet. Early humans ate rough, coarse foods like roots, nuts, and raw meat that required powerful chewing. Having extra molars in the back of the mouth provided more grinding surface for these tough foods. Ancient humans also lost teeth more frequently due to wear and lack of dental care. Wisdom teeth erupted in late adolescence to replace molars that had worn out or been lost. Our ancestors had larger jaws with more space to accommodate these third molars. Over thousands of years, human diets have become much softer with cooked foods that require less chewing power. Our jaws have gradually become smaller through evolution because we don’t need the same chewing capacity. Modern humans still develop wisdom teeth because evolution is a slow process that takes many generations. This mismatch between jaw size and tooth number is why wisdom teeth cause problems today. Some anthropologists predict that far in the future, humans might stop developing wisdom teeth altogether.
When Wisdom Teeth Can Stay
A small percentage of people, maybe 20 to 30 percent, can keep their wisdom teeth without problems. These lucky individuals have jaws that are large enough to accommodate the extra molars comfortably. Their wisdom teeth grow in straight and properly aligned with the rest of their teeth. The teeth fully erupt through the gums so there are no partially covered flaps that trap food and bacteria. They can reach their wisdom teeth with a toothbrush and floss to keep them clean and cavity free. There’s no crowding or pushing against the other teeth that could cause alignment problems. X-rays show healthy bone around the wisdom teeth with no signs of cysts or other issues. These people need to maintain excellent hygiene and get regular checkups to make sure their wisdom teeth stay healthy. Even wisdom teeth that seem fine in your twenties can develop problems later as you age. We monitor patients who keep their wisdom teeth closely to catch any issues before they become serious.
Warning Signs That Extraction Is Needed
Several signs indicate your wisdom teeth are causing problems and should probably be removed. Pain, swelling, or tenderness in the back of your mouth near where wisdom teeth are located. Recurring infections in the gum tissue around a partially erupted wisdom tooth that won’t stay away. Jaw stiffness or difficulty opening your mouth fully, especially in the morning. Bad breath or a bad taste that won’t go away despite good oral hygiene. Pressure or aching in your other teeth as wisdom teeth push against them trying to erupt. Crowding or shifting of your front teeth after they had been straight for years. Cavities developing on wisdom teeth because you can’t reach them to clean properly. Cavities on the molars right in front of wisdom teeth where food gets trapped. Cysts showing up on X-rays around impacted wisdom teeth that haven’t erupted. Even without symptoms, X-rays might show wisdom teeth growing at bad angles that will eventually cause problems.
The Risks of Keeping Problem Wisdom Teeth
Leaving problematic wisdom teeth in place creates risks that often worsen over time. Partially erupted wisdom teeth create pockets where bacteria thrive and cause repeated infections. These infections can spread to your cheek, throat, or other areas of your head and neck in severe cases. Impacted wisdom teeth can damage the roots of the molars right in front of them. The pressure from wisdom teeth trying to erupt can undo orthodontic work and crowd your front teeth. Cysts or tumors can develop around impacted wisdom teeth and destroy surrounding jawbone. Wisdom teeth that are impossible to clean become cavity-prone and often need extraction eventually anyway. The older you get, the more difficult wisdom tooth extraction becomes and the longer recovery takes. Bone becomes denser with age, roots become longer and more curved, and healing slows down. Dentists often recommend removing problematic wisdom teeth in late teens or early twenties when surgery is easiest. Waiting until your thirties, forties, or beyond means more complicated surgery and recovery. The risks of leaving bad wisdom teeth far outweigh the discomfort of having them removed at the right time.
Special Circumstances and Considerations
Some situations require extra thought about whether to remove or keep wisdom teeth. Patients undergoing radiation therapy to the head or neck should have problematic wisdom teeth removed before treatment starts. People taking bone strengthening drugs for osteoporosis face extraction complications, so preventive removal makes sense. If you’re about to have major heart surgery, your cardiac surgeon might request wisdom tooth removal to eliminate infection sources. Patients moving to remote areas where dental care is limited should consider preventive extraction of questionable wisdom teeth. Pregnant women with impacted wisdom teeth might want them removed before getting pregnant to avoid problems during pregnancy. Athletes and military personnel sometimes have wisdom teeth removed preventively to avoid problems during important times. People with weakened immune systems from conditions like HIV or cancer treatment are more vulnerable to wisdom tooth infections. In developing countries where access to dental care is limited, removing wisdom teeth preventively makes more sense. Your individual circumstances and medical history play a big role in the decision about your wisdom teeth.
Get Expert Wisdom Tooth Evaluation
Not sure whether your wisdom teeth should stay or go? The experienced dentists at Picasso Dental Clinic will evaluate your specific situation with X-rays and examination. We’ll give you honest advice about whether extraction is necessary or if your wisdom teeth can stay. Our clinics in Hanoi, Da Nang, and Ho Chi Minh City offer comfortable, safe wisdom tooth removal when needed. Schedule your evaluation today and get the personalized guidance you need.
