The common council of dentists is to remove the “eights” immediately after their appearance, even if they do not cause any discomfort. We decided to check whether such a recommendation is justified.
Sites of many dental clinics In various cities of Russia, they recommend or even insist on the need to remove wisdom tooths - sometimes all straightaway. Recommendations for the removal of "eight" divided Dentists and in volunteers in women's magazines. The following consideration is often given as one of the arguments: our distant ancestors ate more rough food, mostly thermally unprocessed; Over the millennia, the diet of a person has changed, the food has become softer, but the wisdom teeth have been preserved and now, instead of benefit, they bring problems. However, not all specialized resources completely agree with this point of view: some writethat removal is an optional procedure and should be carried out strictly according to indications, while others should called reasons for save "Eights."
The teeth of wisdomor third molar, is the last group of molars that appear in the human mouth. Usually they erupt from 17 to 25 years, in the final phase of the development of the dentition system. However, they may appear later - both at 40, and at 50.
Historically, the teeth of wisdom performed a number of important functions for our ancestors. The diet of ancient people consisted of hard and rough food, such as raw meat and fibrous plants. Wisdom teeth were necessary to effectively grind and chew these hard products. At a time when the loss of teeth was common due to wear or injuries, wisdom teeth served as a replacement for lost molars. Over time, a person’s diet has changed due to the cooking and processing of foods, the food has become softer, the quality of dental services has improved, and the need for additional molars has disappeared. As a result, the teeth of wisdom became rudiments - parts of our body, which remained from previous times, but do not fulfill their original function.
Most modern diets do not require the degree of grinding that our ancestors needed. The size of the human jaw also decreased Over time, and wisdom teeth stopped enough space for the correct teething. This is often Curses To complications, such as impaired (when the teeth cannot be completely cut through) and their incorrect position in the mouth. Also, the lack of space can cause the crowding of other teeth, and to prevent further complications, wisdom teeth have to be removed. In addition, due to the location of the third molar of them It is hard to cleanwhich can also cause diseases of the oral cavity.
Of course, if the wisdom teeth grow incorrectly, injure the oral cavity, remove other teeth or interfere with orthodontic treatment and the correction of the bite, their removal will be removed effective solving the problem. However, in the case of completely and correctly grown teeth, wisdom that do not create any problems, dentists still often recommend getting rid of these rudiments.
Checking in practice whether to remove wisdom teeth or not is quite problematic. Firstly, such studies should be quite long in time: it is advisable to describe the interval from the age at which wisdom teeth can begin to erupt to a very elderly one in order to evaluate their influence on the state of the oral cavity for many years. Secondly, it should be noted that some people (from 5% to 37% depending on the population) teeth of wisdom in principle absent. Therefore, an analysis, which potentially can answer this question, should include the most wide sample in composition. Thirdly, the dentist’s regular observation in itself, necessary to participate in the study, will most likely change the approach to the hygiene of the oral cavity and protect from a number of problems.
Unfortunately, there are no research that would cover decades of observations and tens of thousands of participants. All experiments conducted are shorter in time or less in sample. For example, in 1998, scientists from the dental school of Bristol Bone The results of the five -year observation of 164 young people who had previously corrected the bite. Researchers were interested in whether the removal or preservation of third molar on the dentist displacement affected. Those who did not remove wisdom teeth, an average offset was only 1 mm larger, which is extremely insignificant taking into account the size of the dentition. However, the main problem of this observation was that 53% of the volunteers initially included in the study did not participate in the assessment of the state of the jaw five years later, and from the group of those who retained third molars there were 15% more. That is, in general, the data analyzed by scientists are very incomplete and cover a very short period. In addition, there is no data, whether the participants removed wisdom teeth in order to prevent or for medical reasons.
IN research 2013, conducted by the Kreeton University (Nebraska, USA) dentistry school, there are significantly more time periods - as many as 25 years. The sample included 416 men with a large age -related scatter - from 28 to 76 years. Previously, they were all examined and divided into groups. The first included people with the absence of wisdom tooths (those who did not have wisdom teeth, and those who were removed before the start of the study), in the second - people with fully erased teeth of wisdom, in the third, those who had wisdom teeth were included in its infancy. The last group was additionally divided into two subgroups: those whose upper part of the rudiment remained in the bones, and those who had it at the level of the soft tissues of the gums. Scientists were interested in the risk of the carious defeat of neighboring, second molar (popularly called "seven"). It turned out that men who had no wisdom teeth at the time of inclusion in the study were at the least risk of such caries. For those who have “eights” have grown completely or are in its infancy in the bone, such a risk is higher by 1.74 and 2.16, respectively. And above all the risk of caries on neighboring teeth in those whose wisdom teeth were in the infancy at the level of soft tissues.
However, a group without "eights" turned out to be heterogeneous. Firstly, there were men who were born without teeth of wisdom, and those who were removed for various reasons (including, probably for prevention, and due to problems in the oral cavity) and at different times. Secondly, the age sample was too heterogeneous. The study started in 1988, that is, the oldest participants could provide the first dental care at the beginning of the 20th century, and the youngest - already at the end. Technologies for helping and maintaining oral hygiene during this time have changed significantly, so equalizing 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 the increased “eight” affect the risk of caries of the neighboring “seven”. Scientists came to the conclusion that the presence of an “eight” almost did not affect the risk of decay of a neighboring tooth (the difference was less than 1%). However, two years are a very short gap, and caries can develop very slowly, so it is impossible to extrapolate this data to the risk throughout life.
In 2020, Kokrainovskoe cooperation Published The third edition of its meta-analysis trying to answer the question of whether there are at least some advantages of the procedure for the preventive removal of third molar. Scientists noted that all existing studies have no evidence of a high level of reliability: in some studies there is too small sample, there are no control groups in others, thirdly, patients are observed for an insufficient period of time, etc. However, on the basis of existing data, experts concluded that there is no reason to recommend wisdom tolerance for prevention purposes. Removal Maybe It is associated with a number of complications - pain in the postoperative period, infection of the hole at the site of the removed tooth, injury of neighboring teeth during surgery, bleeding or damage to the nerve. Since there is no evidence of a long -term improvement in the quality of life and preserving the health of the oral cavity after removing the wisdom tooth, experts recommend that the patient’s personal preferences and national clinical guidelines take into account. If the patient decides to preserve the teeth of wisdom, he is advised to carefully monitor the hygiene of these sections of the dentition and regularly visit the dentist. However, this recommendation is also applicable to those who have wisdom teeth removed or absent from nature.
Clinic Expert Cleveland Neutan Yanovich agree With colleagues from Kokrain's cooperation: wisdom teeth, which have grown correctly, do not need to be removed until they are healthy and do not cause discomfort. Clinic specialist Majo Kyle Ettinger voices Similar conditions: if the tooth is healthy, it has grown completely and is located correctly, and hygiene rules are respected, then there is no need to remove such a tooth. The American Association of Dentists also Turns Attention that it is necessary to carefully monitor the hygiene of wisdom tooths - in particular, do not neglect the dental thread to clean them.
Thus, there is no sufficient scientific data to justify the preventive removal of wisdom tooths. Existing studies do not show any improvement in the quality of life and reducing the risk of oral diseases in case of conservation. Of course, this applies only to healthy, completely and correctly cut through tooths. If the wisdom teeth shift the dentition, cause pain and discomfort, injure the soft tissues of the oral cavity, their removal is precisely justified.
Image on the cover: GPT 4O
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