Wisdom teeth, officially known as third molars, often require attention due to various issues. While most individuals develop four, one in each corner of the mouth, human dentition can present variations. This raises questions about having more than the usual set.
Understanding Wisdom Teeth
Wisdom teeth are the final set of molars to erupt, typically appearing between the ages of 17 and 25. They are positioned at the very back of the mouth, behind the second molars. Most adults have four wisdom teeth, one in each of the four quadrants of the jaw. However, many people may have fewer than four, or even none at all.
When There Are More Than Four
It is possible for a person to have more than four wisdom teeth. This condition is known as hyperdontia, or supernumerary teeth. When in the wisdom tooth region, behind the third molars, they are often called “fourth molars” or “distomolars.” While less common than four wisdom teeth, supernumerary wisdom teeth are a recognized dental occurrence.
Supernumerary wisdom teeth occur in approximately 1-3% of the population. These extra molars can vary in shape and size, sometimes resembling normal molars or appearing rudimentary and conical. They can be impacted, not fully erupting through the gum line, or they may partially erupt. The occurrence of more than four wisdom teeth, such as six or even eight (double wisdom teeth), is rarer but has been documented.
Why Extra Wisdom Teeth Occur
The exact reasons behind the development of extra wisdom teeth are not fully understood, but several theories exist. Genetic factors are believed to play a role, with a higher likelihood if a close family member has also had extra teeth. Another theory involves the hyperactivity of the dental lamina, the tissue responsible for tooth development. If this tissue remains overly active after the normal set of teeth has formed, it can lead to the formation of additional tooth buds.
Some theories also suggest atavism, the re-emergence of ancestral traits. Early human ancestors are thought to have had more molars to process their diet, and the presence of extra molars could be a genetic throwback to these earlier dental patterns. Environmental factors during development may also contribute, though their mechanisms are less clear. The etiology of supernumerary teeth is likely multifactorial, involving a combination of genetic and developmental influences.
Managing Additional Wisdom Teeth
The presence of additional wisdom teeth can lead to various oral health concerns, similar to issues with typical wisdom teeth. Common problems include impaction, where the tooth cannot emerge, leading to pain, infection, or damage to adjacent teeth. Extra molars can also cause overcrowding, potentially leading to misalignment of other teeth or orthodontic issues. In some cases, cysts or tumors can form around impacted supernumerary teeth, requiring more extensive treatment. Maintaining proper oral hygiene can also become challenging with extra teeth, increasing the risk of cavities and gum disease.
These extra teeth are often discovered incidentally during routine dental X-rays, as they may not cause immediate symptoms. Once detected, management depends on several factors: number, location, and impact on oral health. If asymptomatic and not causing problems, a dentist may opt for a “watch and wait” approach, monitoring them with regular check-ups and X-rays. If they cause pain, discomfort, or pose a risk, surgical extraction is often recommended. The extraction process is similar to that for regular wisdom teeth, though the unusual positioning of supernumerary teeth may sometimes require more intricate techniques.