Dr. A. Omar Abubaker was surprised when a fellow oral surgeon came into his office to have his wisdom teeth removed. It wouldn't have been unusual if the patient were in his 20s, but this man was 74 years old. He called Abubaker when his wisdom teeth became bothersome.
"Earlier in life, he declined having them removed because he was not having any problems with them," says Abubaker, professor and chairman of the department of oral and maxillofacial surgery in Virginia Commonwealth University's School of Dentistry. "You would think an oral and maxillofacial surgeon would know better."
Those pesky backmost molars are nuisances to nearly everyone. In fact, the third molars serve no purpose, although that hasn't always been the case. Going back many, many generations, our ancestors had larger jaws that could accommodate many teeth. The molars were needed to help chew plants, nuts and berries.
"With time, human jaws got smaller," Abubaker explains, "so there is less space to accommodate these teeth. And that is why they frequently become impacted and cannot erupt. The human diet has changed, and so these teeth are no longer useful."
Some people, like Abubaker's 74-year-old patient, wait until their wisdom teeth become problematic before they decide to have them removed.
"People who keep their wisdom teeth have a higher degree of more virulent bacteria, which can contribute to periodontal problems," says Dr. Corey Burgoyne of Commonwealth Oral & Facial Surgery.
It's best to get the surgery done in your teens or 20s, she adds. "The bones heal significantly better in patients who are age 25 or younger, so most people do come in during their teen years."
Over the years, Dr. Charles R. Counts of Counts & King has noticed a trend: The average age of wisdom-teeth patients is going down. "We're now seeing kids in their early teens coming in [for the surgery]," he says.
Many of Burgoyne's younger patients have all four wisdom teeth removed at the same time, using general anesthesia. In lieu of general anesthesia, some patients may opt for local anesthesia, laughing gas or sedatives by way of I.V.
According to Abubaker, about 85 percent of third molars will need to be removed at some point either because of the symptoms they cause or "to prevent problems from occurring."
After the procedure, patients may have some degree of swelling and pain for two to five days. "There are medications given to minimize the swelling and manage the pain and discomfort," Abubaker says.
How these useless third molars came to be called "wisdom teeth" is an easy answer, Abubaker says. "They [develop] at an age, usually between 17 and 25, when people are presumably old enough to have supposedly gained some wisdom." Maybe that's why so many folks have them taken out before the age of 25 — they've tapped into that bank of wise thinking.
