Subjects: R and D
Most people are born with 4 wisdom teeth, which normally descend below the gum line between the ages of 17 and 25. Wisdom teeth are believed to have been important to our hunter-gatherer ancestors, whose coarse diet caused teeth to grind down and wear out.
The jaws of our hunter-gatherer ancestors were much larger than ours however, and for many of us there isn’t enough room in our mouths to accommodate the late-comers.
In these cases, wisdom teeth can become impacted (trapped in the jawbone) or erupt through the gum line only partially—a situation that predisposes to bacterial infections of the jaw, periodontal disease and tooth decay.
Of course, most people experience none of these complications, and the prophylactic surgical procedure designed to remove these risks can cause complications of its own. These include infections, postoperative bleeding and even perforated sinuses or nerve damage.
So how does one decide whether to have wisdom teeth removed, even if they are causing no problems? It turns out the scientific literature contains almost no guidance on the matter.
The American Dental Association for example, has not published guidelines for dealing with wisdom teeth. It prefers to let care givers decide on a case-by-case basis.
Thankfully, the NIH recently launched a study that might shed light on the subject. The study, led by Greg Huang of the University of Washington, will record the reasons given by general dentists when they suggest either pulling or keeping wisdom teeth, and then track patient outcomes for 2 years.
Meanwhile, Chevy Chase dentist Steven Kahan, who has dealt with the problem for 40 years, told the Washington Post, “It is the kind of thing where all of us make a somewhat educated guess.”