Common advice from dentists is to remove figure eights immediately after they appear, even if they do not cause any discomfort. We decided to check whether such a recommendation is justified.
Many sites dental clinics in various cities of Russia they recommend or even insist on the need to remove wisdom teeth - sometimes all straightaway. Recommendations for removing “eights” share dentists and in promotional articles in women's magazines. The following consideration is often given as one of the arguments: our distant ancestors ate coarser food, mostly thermally unprocessed; Over the millennia, the human diet has changed, food has become softer, but wisdom teeth have been preserved and now, instead of benefiting them, they bring problems. However, not all specialized resources fully agree with this point of view: some writethat removal is an optional procedure and should be carried out strictly according to indications, and others called reasons for doing so save "eights".
Wisdom teeth, or third molars, are the last group of molars to appear in a person's mouth. They usually erupt between the ages of 17 and 25 years, in the final phase of development of the dental system. However, they can appear later - at 40 or 50.
Historically, wisdom teeth served a number of important functions for our ancestors. The diet of ancient people consisted of tough and rough foods such as raw meat and fibrous plants. Wisdom teeth were needed to effectively grind and chew these hard foods. At a time when tooth loss was common due to wear and tear or injury, wisdom teeth served as replacements for lost molars. Over time, the human diet has changed through cooking and processing of foods, food has become softer, the quality of dental care has improved, and the need for additional molars has disappeared. As a result, wisdom teeth have become rudiments - parts of our body left over from previous times, but not fulfilling their original function.
Most modern diets do not require the degree of grinding that our ancestors needed. The size of the human jaw is also decreased Over time, wisdom teeth no longer have enough space to erupt properly. This is often leads to complications such as impaction (when teeth fail to fully erupt) and their malposition in the mouth. Also, lack of space can cause crowding of other teeth, and wisdom teeth must be removed to prevent further complications. In addition, due to the location of the third molars, they hard to clean, which can also cause oral diseases.
Of course, if wisdom teeth grow incorrectly, injure the oral cavity, displace other teeth, or interfere with orthodontic treatment and bite correction, their removal will be effective solving the problem. However, even in the case of fully and correctly grown wisdom teeth that do not create any problems, dentists still often recommend getting rid of these rudiments.
It is quite problematic to check in practice whether it is worth removing wisdom teeth or not. First, such studies must be sufficiently extended in time: it is advisable to describe the interval from the age at which wisdom teeth can begin to erupt until very old age, in order to assess their impact on the condition of the oral cavity over many years. Secondly, it should be taken into account that some people (from 5% to 37% depending on the population) have wisdom teeth in principle none. Therefore, an analysis that can potentially answer this question should include as wide a sample as possible. Third, the mere regular dental check-ups required to participate in the study will likely change your approach to oral hygiene and protect you from a number of problems.
Unfortunately, there are no studies that would cover decades of observation and tens of thousands of participants. All experiments performed were shorter in time or smaller in sample size. For example, in 1998, scientists from the Bristol Dental School let down the results of a five-year observation of 164 young people who had previously had their bite corrected. The researchers were interested in whether the removal or retention of third molars affected the movement of the dentition. In those who did not have their wisdom teeth removed, the displacement was on average only 1 mm larger, which is extremely insignificant considering the size of the dentition. However, the main problem with this observation was that 53% of the volunteers initially included in the study did not participate in the assessment of the condition of the jaw after five years, and from the group that retained third molars there were 15% more of these. That is, in general, the data analyzed by scientists is very incomplete and covers a very short period. In addition, there is no data whether participants had their wisdom teeth removed for preventive purposes or for medical reasons.
IN research 2013, conducted by the School of Dentistry of Creighton University (Nebraska, USA), the time period is much longer - as much as 25 years. The sample included 416 men with a wide age range - from 28 to 76 years. They were all preliminarily examined and divided into groups. The first included people with no wisdom teeth (it included both those who naturally did not have wisdom teeth and those who had them removed before the start of the study), the second included people with fully erupted wisdom teeth, and the third included those whose wisdom teeth were in their infancy. The latter group was further divided into two subgroups: those in whom the uppermost part of the bud remained in the bone, and those in whom it was at the level of the soft tissue of the gums. Scientists were interested in the risk of carious lesions of neighboring, second molars (popularly referred to as “sevens”). It turned out that men who did not have wisdom teeth at the time of inclusion in the study were at the lowest risk of such caries. In those whose “eights” have grown completely or are present in their infancy in the bone, this risk is higher by 1.74 and 2.16, respectively. And the risk of caries on neighboring teeth is highest in those whose wisdom teeth were in their infancy at the level of soft tissue.
However, the group without “eights” turned out to be heterogeneous. Firstly, there were men who were born without wisdom teeth, and those who had them removed for various reasons (including, probably, for the purposes of prevention, and because of problems in the oral cavity) and at different times. Secondly, the sample was too heterogeneous in age. The study started in 1988, which means that the oldest participants could have received first dental care as early as the beginning of the 20th century, and the youngest participants - at the end. Technologies for helping and maintaining oral hygiene have changed significantly over this time, so equating people with such an age difference is also not entirely correct.
In 2014, American researchers shared the results of a two-year observation of 801 patients aged 16 to 22 years. They compared whether the presence of a grown “eight” affected the risk of caries of the neighboring “seven”. The scientists concluded that the presence of the “eight” had almost no effect on the risk of caries of the adjacent tooth (the difference was less than 1%). However, two years is a very short period, and caries can develop very slowly, so these data cannot be extrapolated to a lifetime risk.
In 2020, the Cochrane Collaboration published the third edition of his meta-analysis, which attempts to answer the question of whether there is any benefit to the procedure of prophylactic extraction of third molars. Scientists noted that all existing studies do not have evidence of a high level of reliability: some studies have too small a sample, others do not have a control group, others follow patients for an insufficient period of time, etc. However, based on the existing data, experts concluded that there is no reason to recommend that patients have their wisdom teeth removed for preventive purposes. Removal Maybe be associated with a number of complications - pain in the postoperative period, infection of the socket at the site of the extracted tooth, injury to adjacent teeth during surgery, bleeding or nerve damage. Since there is no evidence of long-term improvements in quality of life and preservation of oral health after wisdom tooth removal, experts recommend taking into account both the patient's personal preferences and national clinical guidelines. If the patient decides to keep his wisdom teeth, he is advised to carefully monitor the hygiene of these areas of the dentition and regularly visit the dentist. However, this recommendation also applies to those who have wisdom teeth removed or naturally missing.
Cleveland Clinic expert Nathan Yanovich agree with colleagues from the Cochrane Collaboration: wisdom teeth that have grown correctly do not need to be removed as long as they are healthy and not causing discomfort. Mayo Clinic specialist Kyle Ettinger voices similar conditions: if the tooth is healthy, fully grown and positioned correctly, and hygiene rules are followed, then there is no need to remove such a tooth. The American Dental Association also draws Please note that it is necessary to carefully monitor the hygiene of your wisdom teeth - in particular, do not neglect dental floss to clean them.
Thus, there is insufficient scientific evidence to justify prophylactic wisdom tooth removal. Existing studies do not show any improvement in quality of life or reduction in the risk of oral diseases if they persist. Of course, this only applies to healthy, fully and correctly erupted teeth. If wisdom teeth displace the dentition, cause pain and discomfort, or injure the soft tissues of the oral cavity, their removal is definitely justified.
Cover image: GPT 4o
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