If you look at the 2 skulls pictured above, and focus on the mandible (or the jaw bone), the skull on the left is of our early ancestor, Homo Erectus, and the skull on the right is of us, Homo Sapiens.
Take a look at the bone available behind the teeth on the left versus the right, see any difference? Homo Erectus never had trouble with enough room for his wisdom teeth (or 3rd molars). In fact, Homo Erectus probably didn’t have much trouble with his/her teeth to begin with because they ate a plant/meat based diet which did not include soda, candy and other refined sugars.
If you rule out the occasional breakage of a tooth on a stone or fruit pit, they survived quite well without us dentists. No need for fillings, extractions or orthodontics.
Fast-forward a couple hundred thousand years and we have quite a different story to tell. We now cart out cases of soda from the grocery store, along with our Girl Scout cookies, donuts, Gatorade, cookies, cakes and candy. These items stick and wash over our teeth destroying the enamel which then weakens it for chewing causing cracks and holes in our teeth.
Since we also have smaller jaw bones (mandibles) we do not have enough room for the 3rd molar to erupt at about the age of 16. In fact, nature is trying to keep up with us by leaving out the 3rd molar tooth bud in a lot of adults. We frequently see patients who have never developed most or all of their wisdom teeth, but for the vast majority of us, we need to get them out.
They come in only partially, leaving a “tunnel” into the jaw bone for bacteria with can cause abscesses (pericornitis). They come in sideways, leaning on your good tooth in front of it and cause it to decay thereby having to have 2 molars extracted. They don’t come in at all which can sometimes lead to cyst formation with the pressure moving the tooth into a different part of the jaw (no, you don’t feel this).
All-in-all, 3rd molars are trouble makers and I recommend they are extracted in almost all our teenage population. We refer them to our excellent group of oral surgeons in town who often put the patient “to sleep” or take them out with laughing gas.
I have seen far too many older adult patients where their wisdom tooth causes problems, and unfortunately, at that age, we don’t heal like we did when we were 16.
So, if your son or daughter is in the 16-19 year-old age range, have a panoramic x-ray taken of their jaw to see if they have 3rd molars and where they are at. It’s almost guaranteed they won’t have enough room.
skull picture courtesy of Dennis O’Neil anthro.palomar.edu
x-ray courtesy of http://www.childressdental.com