Wisdom teeth, also known as third molars, are the last set of teeth to emerge, typically appearing in the back of the mouth between ages 17 and 25. Most individuals have four wisdom teeth, one in each corner of the mouth. However, some people have fewer, or possess additional teeth. The presence of additional teeth raises questions about dental development and whether a second set of wisdom teeth is possible.
Understanding Supernumerary Teeth
The presence of teeth beyond the standard count is called hyperdontia, with these extra teeth known as supernumerary teeth. When they appear in the wisdom tooth region, they are extra wisdom teeth, not a second complete set. These additional molars are classified by position. Distomolars are behind the third molars, while paramolars are next to the molars, on the cheek or tongue side.
Supernumerary teeth vary in form. They might be conical (peg-shaped) or tuberculate (barrel-like with multiple cusps). Some resemble normal teeth and are termed supplemental, while others, called odontomas, are disorganized masses of dental tissue. Though uncommon, affecting 0.1% to 3.8% of the population, their presence can lead to various oral health complexities.
Why Extra Wisdom Teeth Occur
The exact reasons for extra wisdom teeth are not fully understood, but several theories exist. One theory suggests hyperactivity of the dental lamina, the tissue band in the jaw responsible for tooth development, can form additional tooth buds. Genetic predisposition is another factor, with genes like MSX1, MSX2, AXIN2, PAX9, and Wnt signaling pathways implicated in abnormal tooth development.
These extra teeth can also be associated with inherited conditions. Syndromes like Gardner’s syndrome and cleidocranial dysplasia increase the likelihood of supernumerary tooth formation. Studies indicate they are more frequently observed in males than in females.
Detecting and Addressing Extra Wisdom Teeth
Extra wisdom teeth are often discovered incidentally during routine dental examinations. They typically remain asymptomatic and are identified through dental X-rays, particularly panoramic radiographs, which provide a comprehensive view of the entire dental arch. These additional teeth can lead to various complications. They may cause crowding, leading to misalignment of existing teeth.
Impaction is another common issue, where the extra tooth becomes trapped in the jawbone or gums and cannot fully erupt. This can result in localized pain, swelling, and an increased risk of infection. Supernumerary teeth might also contribute to cyst formation or damage to adjacent teeth, making early detection important.
Management and Treatment Approaches
Once extra wisdom teeth are detected, their management approach depends on several factors. Dental professionals consider the tooth’s position, its potential to cause problems, and the patient’s overall oral health. If the supernumerary tooth causes issues like pain, infection, or crowding, extraction is often recommended.
The removal procedure varies based on its location and impaction. If the tooth is asymptomatic, a monitoring approach may be adopted, involving regular check-ups to observe its development and impact on surrounding structures. This allows for intervention only if complications arise.