Like puberty and your first heartbreak, the painful process of getting your wisdom teeth removed is one of those cumbersome coming-of-age rituals that many people are forced to endure. But why do we have wisdom teeth when they seem to only cause problems? Read on to find out more about the humble third molar—the last tooth many of us get as adults.
Imagine, for a moment, that you’re a prehistoric man or woman. You subsist largely on raw meat, roots, and leaves. You’d need some pretty powerful chompers to cut up your food, right? That was where your third molars—also known as wisdom teeth—came in. Today, our palates are a little more refined, and we prefer softer foods (think avocado toast and smoothies). Plus, modern cooking tools have put our wisdom teeth out of business.
They’re not just pointless, though—they’re also problematic. Wisdom teeth are a “scar of human evolution,” according to Princeton University researcher Alan Mann. About 800,000 to 200,000 years ago, early humans’ brains started growing at a rapid pace—so much so that they ballooned to three times their original size. When that happened, it changed the shape of the braincase (the back part of the skull) and its position relative to the dental arcade (rows of teeth). The dental arcade shortened, and suddenly there was no longer enough room for third molars. And since the genes that determine the makeup of our teeth evolve separately from those that control brain development, humans were stuck dealing with the consequences of a crowded mouth, according to Live Science.
2. Nature may eventually sort it out.
On the bright side, scientists say evolution may eventually take care of the problem, meaning that people in the future would not develop wisdom teeth. It’s anyone’s guess as to when this will occur, though. “On the evolutionary scale, if I had to predict down the road—centuries probably—wisdom teeth are going to be one of the things that humans probably won’t have anymore,” Dr. William McCormick, clinical assistant professor at West Virginia University’s School of Dentistry, told Mental Floss in 2018.
It’s possible that you have one, two, three, four, or none at all. Another possibility, although it’s rare, is to have more than four wisdom teeth, which are called supernumerary teeth. “In my career, I have seen two cases where patients have had fourth molars—or two sets of wisdom teeth,” McCormick said. (Comparatively, humans’ ancestors had quite the mouthful, with 12 wisdom teeth in total.)
According to McCormick, genetic factors like jaw size might determine the number of wisdom teeth that a person has. Your lineage may also have something to do with it. Practically no Indigenous Mexicans have third molars, but almost 100 percent of Aboriginal Tasmanians have at least one wisdom tooth. Americans of African and Asian descent are also more likely than people of European descent to have fewer than four wisdom teeth. This variation can be attributed to a random genetic mutation that arose thousands of years ago, thereby preventing the formation of wisdom teeth. This mutation is more prevalent in certain populations.
4. ... as does the number of roots that each wisdom tooth has.
The roots are the part of the tooth that form first, and then push the bud (the part that’s visible in your mouth) through your gums. While wisdom teeth typically have two or three roots, they can have more. McCormick personally removed his wife’s wisdom teeth in the ‘70s and was surprised to see that one of them had five roots. “It looked like a spider. It was not a pleasant extraction,” he said.
For that reason, if wisdom teeth need to be removed, it’s easier to do so before the roots start to take hold. “When the roots are totally formed, they’re anchored like a tree that’s been in your backyard for 100 years,” said Dr. Ron Good, an orthodontist in southwestern Pennsylvania who runs a family practice with his brother, Dr. Bob Good. On the other hand, surgeons want some roots to grab hold of, because removing a tiny tooth bud is “like extracting a marble,” Dr. Ron told Mental Floss in 2018.
According to Guinness World Records, the oldest person to ever grow a wisdom tooth was 94 years old. McCormick said there‘s a wide variation in ages when eruption occurs; he once had a 65-year-old patient with dentures whose wisdom tooth had started to erupt (poke through the gums). “They’re crazy little beasts. You never know what you’re going to see,” he said.
Apparently, wisdom teeth have been acting erratically for thousands of years. Aristotle documented this phenomenon in his book The History of Animals: “Cases have been known in women upwards of 80 years old where at the very close of life the wisdom-teeth have come up, causing great pain in their coming; and cases have been known of the like phenomenon in men too.”
In most cases, though, wisdom teeth erupt when you’re in your late teens or early twenties.
6. The first impacted wisdom tooth was recorded about 15,000 years ago.
When wisdom teeth don’t have enough room to grow normally, they get stuck in the jaw and fail to erupt. These are called impacted teeth. The oldest known case of an impacted tooth was found in the skeleton of a 25- to 35-year-old woman who died some 15,000 years ago. This case cast doubt on the theory that impacted teeth are a modern ailment, caused by recent changes in our dietary habits.
Many people get their wisdom teeth removed, even if there isn’t any pain or discernible problem aside from impacting. Known as prophylactic surgery, this preventative practice is common in the U.S., but in recent years there has been some debate as to whether it’s necessary. One popular theory holds that most people either have problems with their wisdom teeth or will at some point in the future. “It’s hard to get a percentage, but probably 75 to 80 percent of people do not meet the criteria of being able to successfully maintain their wisdom teeth,” Dr. Louis K. Rafetto, who headed a task force on wisdom teeth, told The New York Times in 2011.
About 3.5 million extraction surgeries are performed each year, and according to another estimate, that adds up to be 10 million individual wisdom teeth pulled annually. Dr. Ron and Dr. Bob, of Good Orthodontics, are both of the opinion that wisdom teeth are ticking time bombs. “In our mind, we feel that wisdom teeth, in general, are of no value and are only potential problems,” Dr. Bob said. He added that third molars can interfere with your bite and cause your teeth to wear down, and in some cases, can also cause cysts, tumors, nerve damage, periodontal disease (affecting the gums and other areas around the teeth), and TMJ disorders (affecting the jaw joint). Plus, if your teeth are too crowded and you aren’t able to brush and floss them normally, it can lead to additional issues, such as gum disease and cavities.
8. ... while others say you should leave healthy wisdom teeth alone.
Dental practitioners in the UK put an end to routine wisdom tooth extractions in 1998, citing a study at the University of York that reportedly found no scientific evidence to support the practice [PDF].
Opposition is building in the U.S., too. Retired dentist Dr. Jay Friedman told How Stuff Works that only about 12 percent of wisdom teeth eventually cause problems. He compared that rate to the 7 to 14 percent of people who experience appendicitis, yet appendixes aren’t removed until they become a medical issue. If this seems to contradict Raffeto's statistics, it’s because there isn’t a whole lot of concrete data on the subject, and much of it is conflicting—so it really comes down to the individual physician’s and patient‘s preferences. “Ask three dentists the same question, and you’re going to get four different answers,” McCormick said with a laugh.
Like Friedman, McCormick doesn‘t support wisdom tooth removal unless there’s an infection, abscess, or other problem. “You have to weigh the surgical risk with what you’re going to try to accomplish,” he said. Like any surgery, wisdom tooth extraction poses a risk, although more serious complications, like fractured jaws and death, are extremely rare. McCormick said some possible side effects include nerve damage, infection, and dry socket (an infection of the tooth socket).
Despite the differing opinions in the dental community, McCormick, Dr. Ron, and Dr. Bob agreed that there’s no prescriptive rule for wisdom tooth removal, and that each patient should be evaluated on a case-by-case basis.
In English, the name wisdom tooth conveys the idea that third molars come in later than other teeth, at a time when you’re older and (hopefully) wiser. Other languages don’t follow the same convention. In Korean, for example, the poetic name for third molars translates to “love teeth,” because it’s around this time (late teens and early twenties) that one typically experiences their first love. The Japanese language also has a creative word for it: oyashirazu, or “unknown to parents,” since most people have already moved away from home by the time their wisdom teeth come in.
10. Wisdom teeth are used in stem cell research.
It turns out wisdom teeth aren’t all bad. Although some of the research is still in the experimental phase, scientists are studying dental stem cells—which were discovered in 2003—to see if they can potentially be used to repair and regenerate tissue.
One study on mice, at the University of Pittsburgh School of Medicine, found that stem cells taken from wisdom teeth could someday be used to repair corneas that have been scarred by infection or injury. Any clinical applications for humans would require more research, though.
“There are studies with dental pulp cells being used to treat neurological disorders and problems in the eye and other things,” Dr. Pamela Robey, of the National Institute of Dental and Craniofacial Research, told CNN. “The problem is, these studies have really not been that rigorous ... the science needs a lot more work.”
A version of this story ran in 2018; it has been updated for 2022.