Home truths, myths and bubbles...

Why the term "wisdom" teeth

In an older time, reaching the age of 21 usually meant you were married, with kids, had a trade, and were an accepted and mature member of society. It was the age you achieved "wisdom".

21 was also the age that your 3rd molars were expected to come through.

There are four 3rd molars, one for each quadrant of your bite. For the lower wisdom teeth, they have the following (generally accepted) statistics...

• Commonly they lean too far forward (44%), and thus the crown leans up under the crown of the forward molar
• They are upright, but still can't erupt because there is simply no room for them to do so (38%).
• They are leaning too far back (6%). This is surgically the HARDEST form of impaction.
• They are lying down (3%). This form causes the greatest difficulty with the forward molar, as normally the wisdom tooth has caused significant bone loss to behind the 2nd tooth.

Lower wisdom teeth are located quite far back in the mouth, and are intimately associated with nerves that supply sensation to your tongue, lip, chin, and inside of cheek.

The upper wisdom teeth are intimately associated with your maxillary sinuses.

Why might a wisdom tooth be impacted?

The most obvious reason for a tooth impaction, is because there is simply not enough room for them to erupt.

Normally jaws are growing as your teeth erupt.

Wisdom teeth are still developing after your jaws and face have stopped growing. Unless your jaws have grown more than normal, or you have lost other teeth, or your wisdom teeth development is normally timed to your normal facial development, then you'll get impacted wisdom teeth.

Impacted wisdom teeth is a feature of the modern age.

Impacted wisdom teeth have been around for as long as Homo sapiens sapiens have been on the planet (about 120,000 years). When we first evolved into man, we didn't live in houses, or have civilisation or read books... and our life spans were much shorter too.

Impacted wisdom teeth is a feature of civilisation (which is around 10,000 years old)... simply because modern society helps us live longer.

Modern society means we have the medicine, and specialist surgical expertise to make impacted wisdom teeth something we don't have to live with all our lives.

After all, we want to live as long and as healthily as possible, and that means keeping all our useful teeth... and not our useless teeth.

I was told by my friend that the dentist was on his chest trying to rip out his tooth... does this happen?

We don't know what happened to your friend. All we do know is that we don't pull wisdom teeth at all. In fact the entire surgical journey is to be as gentle as possible, using forces that you shouldn't notice, and which minimise swelling, and risk of surgical misadventure.

Is it true that you can break your jaw with wisdom teeth surgery?

That unfortunately may have happened... once... a long time ago, in a far away land. Like crocodiles in the New York sewer.

But everything is possible with wisdom teeth surgery, and often the complications may have occured for reasons that are completely not preventable or anticipated. Unfortunately complications that should be completely preventable also do occur... and that produces a community consciousness that maybe all surgeons are painted with the same brush.

That's why surgery should be performed by the specialist you feel most comfortable with. Check their qualifications, as much as their claims to experience.

A surgeon may have been performing a particular operation 10,000 times well.... or 10,000 times badly. Experience and age usually entrenches behaviour and performance, and rarely does behaviour improve without the oversight of specialist peers. If your wisdom tooth surgeon wasn't a specialist to begin with, they don't become specialists because they simply want to be specialists.

You have to earn becoming a specialist. And that usually started with specific specialist training, and continues with specific specialist ongoing education.

Are dentists trained in wisdom teeth surgery?

As Medical Doctors are a broad professional group (that includes GPs and specialists) that treat conditions and disorders of the general body... dentists are also a broad professional group which includes general dentists (dental surgeons) and specialist dentists (endodontists, orthodontists, periodontists, etc).

Taken as a whole profession, dentists treat all disorders and conditions of the mouth and jaws.

General dentists do an undergraduate degree (Bachelor of Dental Surgery or Dental Science or Dentistry) which entitles them to practice all facets of dentistry, including wisdom teeth surgery, to the limit of their undergraduate training. But being a general dentist doesn't entitle one to be called a specialist dentist, unless of course they do a specific and recognised specialist course, and become specifically registered as a dental specialist.

Wisdom teeth surgery is also specifically performed by specialist oral & maxillofacial surgeons. A great deal of their training is spent doing all forms of jaw and facial and oral surgery. Wisdom teeth surgery is specifically and deliberately taught to oral & maxillofacial surgeons, and over many years.

Wisdom teeth occupies a large part of the everyday working practice of most oral & maxillofacial surgeons, and it is why they call themselves "wisdom teeth specialists". Because they are.

Oral & Maxillofacial surgeons also did the same undergraduate degree (Bachelor of Dental Surgery), and so are in a good position to compare the training they received as undergraduate dental students in wisdom teeth surgery, versus the training they received in wisdom teeth surgery as post-graduate specialist surgical trainees, often also after completing a medical degree.

So if you ask a general dental surgeon about wisdom teeth surgery, and an oral and maxillofacial surgeon about wisdom teeth surgery. Only the oral & maxillofacial surgeon has perspective and direct insight to be able to compare both training programmes, and to be able to directly answer that question for you.