Wisdom Tooth: Too wise for wisdom

There are myths and mysteries, apprehensions and fears of all sorts associated with our third molar tooth and in due course of my oral surgery practice I have come to terms with such myths. Most of the people co-relating  eruption of third molar  with advent of wisdom, while few are religiously following  that removing it would make them blind. However, neither the myths are to be believed nor does is make us wise.

If one examined the oral cavity, one would find different types of teeth, ascribed with various functions. These all show a characteristic eruption pattern and any impediment of any sort would make eruption pattern erroneous. The third molar is one such tooth of our oral cavity that has lost its eruption path due to many reasons pertaining to change of diet, phylogeny, growth pattern etc.

And prevalence of this tooth to remain within the bone has increased over the years. The frequency of occurrence is generally 16.7 to 68 % as documented.

Thus, it becomes imperative that early examination and detection of third molar would prevent troubles and complications.

This article will mainly discuss various problems/myths/fears associated with third molar that render people to delay its removal and eventually land them into complications.

Firstly, removal of impacted third molar is not like removing any other decayed tooth. It’s relatively a minor surgical procedure and more so need based surgery, so prophylactic handling of third molar removal becomes essential and it has to be based on rationale, proper diagnosis and robust treatment plan.

Oral and maxillo facial surgeons are equipped with proper evaluation, and they need to weigh risks and complications to the benefits over the long run.

AAOMS, American association of oral and maxillo facial surgeons are of the opinion that about 85% of third molar will eventually need to be removed, either by late adolescence or early adulthood in order to prevent complication associated with it in future.

Problems of pain and infection, cysts and tumours associated with un-erupted third molar are well documented and nothing new in our daily clinical practice as oral surgeons.

Third molars that develop any symptoms or show any pathology related to its growth and eruption need immediate treatment under specialized oral maxillo facial surgeons.

Oral surgeons evaluate such patients based on x-ray imaging, intra oral examination and take measures to remove such symptomatic third molars much painlessly with little or no post operative complications.

However, irony of the fact is that due to unawareness among the people, myths and fears and unethical practices by dental quacks, people not only are sceptical about its removal but also avoid treatment till it becomes grossly complicated.

Unfortunately people of our valley have adapted poor sense of understanding regarding removal of third molars, like

  • removal of this tooth would lead them to loss of wisdom
  • make them blind
  • they may lose their sense of taste
  • even make them deaf.

Whatever the myths, there is no data or any empirical evidence associated with any such claim, though temporary complications and risks with any surgical procedure can never be ruled out.

With advancements in medical sciences, removal of third molars nowadays is considered minimally invasive procedure and is painless, and patients are back to work next day following precautions and better post operative care.

Surgically removal of third molars is conducted only if

  • Insufficient space is available in our jaw
  • Cysts and tumours associated with third molar
  • Repeated  infection and inflammation with the tooth
  • It hinders the eruption of other tooth
  • When one needs orthodontic treatment to align the teeth.

Thus early recognition that third molar is troublesome at times would save a day of pain in future. Ignorance might  not be bliss here.

Dr Tahir is MDS oral maxilla facial surgery.