Sarah D. answered • 11/14/19
Current Master's student in Anthropology
Wisdom teeth do not always cause an issue. Some people never need to have their wisdom teeth removed because they have ample room for their third molars. It is very likely that the majority of molar extractions that occur are unnecessary. These procedures are typically performed as a preventative measure to ensure that no issues arise, and several studies have demonstrated that a large number of wisdom tooth extractions are not medically necessary. In fact, they are only performed routinely in the United States and Australia.
However, as you mentioned, some people do require third molar extraction to prevent pain, abscesses, and infections that occur due to tooth overcrowding or decay. Wisdom teeth are probably not vestigial structures. Humans do generally have larger brains and, as a result, smaller jaws. Beginning around 2 million years ago, human ancestors began manipulating food items in ways that made food more tender, requiring less food processing by the teeth and less musculature in the jaws, and allowing for cognitive development and increased brain size. So overall, humans do have smaller, more crowded jaws compared to our primate contemporaries. However third molars respond to development in a "restricted" or smaller space and sometimes even fail to develop when there is no space in the jaw. Some human populations are more susceptible to issues with wisdom teeth, and problems are most common among people with Anglo-European ancestral origins. This appears to be due to the smaller alveolar ridge size in people of Anglo-European origin.
Early attempts at surgical dentistry (and molar removal) began in the 1900s and were crude and painful, as were most medical procedures at the time. The advent of antibiotics in the 1950s further helped medical professionals fight against infection associated with wisdom teeth. Tooth abscesses and caries are an issue for any animal with a sugar-rich diet, and especially if they eat a large number of soft foods. The rise of agriculture around 10,000 years ago led to an increased number of dental caries, perhaps because of the corresponding increase in the consumption of carbohydrates. Archaeological remains after the advent of agricultural practices often show evidence of tooth drilling or scraping as treatment for tooth infections and cavities. There is evidence of the use of toothpicks to treat infections as far back as Dmanisi (1.8 million years ago). However, for many of our hominid ancestors, tooth infections led to severe deformities and death. Dental disease leading to death is not restricted to humans, however, and wild animals across many taxa have been victims of deadly tooth infections.
