To be or not to be—without wisdom teeth at least. Probably one of the most common dental health questions is whether one should remove their third molars even when they’re not causing problems.

This is because soldiers, particularly Marine Corps, would have theirs removed during boot camp. This is because once these molars become infected, they are such trouble to remove. In fact, they may require a well-trained wisdom tooth surgeon to do the job because of the location.

The infection also carries pathogens that can spread to nearby teeth, increasing their risk of damage. In rare cases, the condition may lead to a life-threatening condition called sepsis.

In reality, there are pros and cons to going through wisdom removal, which emphasizes the importance of discussing such an option with an oral healthcare provider.

But Why Do People Have Wisdom Teeth?

An adult will likely have 32 teeth, including two pairs of third molars. However, the mouth can actually accommodate only so much. The ideal number seems to be 28, which gives all teeth enough time to grow and move. This also means that wisdom teeth sound more like an option than a necessity in human living.

But why do humans have them in the first place? Experts call the third molars the remnants of evolution. If one can recall, our ancestors eat a literally tough diet. In one study on the fossil records, those who had similar teeth as modern humans regularly consumed raw meat, which was tough to break.

Another research in Qesem Cave in Israel revealed that the Paleolithic men and women dined on bone marrow by storing the bones for weeks before eating them. This process might have softened the animal by-product, so they were much gentler on the teeth.

In the end, considering their diet, the prehistoric humans needed as many teeth as they could, so they could chew on their food and digest it properly.

Fast-forward to today. Largely because of agriculture and Industrial Revolution, humans no longer have to hunt. We also have more food options to choose from, and the majority of them are not tough anymore. This means that we’re eating a much softer diet.

Unfortunately, the mouth and the jaw didn’t evolve to match the diet we have today. The softer food doesn’t stimulate their growth to accommodate all the teeth present, and so wisdom teeth are prone to becoming impacted or not develop or grow completely since they are located at the back and they’re the last ones to erupt.

Should You Have Them Removed?

The best answer to this question is it depends on the condition of the teeth and the decision of the patient. Doctors often have two common concerns against third molar extraction: infection and nerve damage.

However, 2021 research by the University of Pennsylvania School of Medicine revealed that getting rid of the third molars may help improve the taste function in the long term—contrary to previous assumptions. Moreover, the researchers estimated that their sense of taste improved between 3 and 10 percent many years after the procedure.

The authors considered two reasons for this improvement. One, the supposed nerve damage that may happen to the taste buds at the front of the mouth might release the inhibition on the nerves that support the taste buds located at the back of the mouth. These changes can then increase the sensitivity of the whole mouth.

Second, other types of research before had shown that the injury to the nerves could heighten the mouth’s sensitivity.

Another growing problem with the removal of wisdom teeth is opioid use. These medications are well-known painkillers to help relieve the symptoms that come with a tooth extraction.

But a 2018 research by the University of Michigan said that a prescription could increase the risk of opioid addiction, particularly among the young population. In particular, patients between 13 and 30 years old who filled a prescription immediately after the procedure were almost three times as likely as their peers to still be asking for the same medications months after.

This is a problem obvious to the dental health community. For this reason, the CDC has released opioid-use guidelines, which mentioned that clinicians should prescribe the lowest dose of the immediate-release opioids. The dentist should also prescribe a quantity just enough for the expected duration of the severity of the pain.

Removing the wisdom teeth may sound easy, but it does require planning and discussion, including the possible consequences to one’s oral health in the future.