Talk:Wisdom tooth/Archive 1

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Archive 1 Archive 2

wrong

  • "Wisdom teeth are sometimes described as an example of a "vestigial" trait that may be disappearing from our species via evolution."

For something to disappear via evolution, it can't just be useless. It has to actually prevent an animal from sucessfully mating as often as if the trait were lacking. Wisdom teeth, like fifth toes and male nipples may be useless, but don't prevent people from mating. I'm removing the bit about disappearing. --Jbaber

Evolution can explain Wisdom teeth being less common because. 1. human mouth is now smaller, 2. Wisdom tooth coming in causes immense pain... perhaps removal, then perhaps infection in the past when medical care was poor. Those with Wisdom teeth were then less likely to reproduce becaues of these problems and therefore now the frequency for people with less teeth is more common... --Martin 198.133.139.5 18:42, 18 April 2007 (UTC)

Removed reference to Answers In Genesis. This is irrelevant. "Wisdom teeth are an example of a vestigial structure, [1] although Answers in Genesis, a Christian organization. denies they are evidence of evolution. [2]" Unbelievable what they will throw into an article on wisdom teeth. Are Al Qaeda's opinions on wisdom teeth included too?????


I can't agree that wisdom teeth haven't prevented people from mating. A trait only needs to make a very small change in percentage reproduction to be selected out. The relevent period isn't now, it's the period between the introduction of modern diet and modern dentistry. Jbaber is arguing that hardly anybody was ever incapacitated or killed by dodgy wisdom teeth in this period, and I find it exceedingly irritating when people presume that they can guess that a trait has no effect on reproduction. And like it or not, true or otherwise, wisdom teeth ARE often described as disappearing through evolution so the statement is quite valid. New scientist has some interesting background: http://www.newscientist.com/channel/life/evolution/dn7035


Gravity is often described as a "force", but physicists will tell us that gravity is merely a term to describe the effects of the curvature of spacetime caused by mass. Just because something is "often described as" being a certain thing or a certain way does not necessarily validate the description.

I can't agree that dodgy wisom teeth would have any significant impact on a breeding population. The question is not whether wisdom tooth complications can lead to death, but whether they tend to lead to death before the individual is able to progenate and pass on the genes for growing wisdom teeth. None of mine have been removed, though I've been advised to have them taken out, as they are all impacted, but I resist due to my lack of any symptoms. I am 33 and have two offspring who are already practically of an age capable of progenation themselves.

The teeth aren't going to be "selected out" by evolution unless they present a significant pressure in favor of the mortality and subsequent lack of progenation of individuals within the population who carry the gene that instructs wisdom teeth to grow.

Those individuals who, by genetic anomaly, do not grow wisdom teeth, would be "selected" by virtue of having a higher chance of procreating and passing on their particular genetic anomaly. That kind of selection isn't going to happen unless the problems that wisdom teeth can potentially lead to prove to be mortal to people before they can breed and pass on the genes for growing wisdom teeth.

Since humans are capable of progenating in their early teens, and most wisdom teeth complications come in the 20s (and in some cases, not until well into the 30s, if at all), I am unable to buy the idea that they are just "dissapearing", or that there is any evidence that they are being selected out.

What would appear to be a change selected by evolutionary pressure is our shorter jaws (well, shorter than our nut-chomping, grain-grinding Australopithecine ancestors'), which no longer accommodate the full set of teeth our DNA insists we grow. -Tenmiles 06:06, 8 July 2006 (UTC)



Does anyone know about how common it is to have dentists remove wisdom teeth without the procedure being necessary?


Extremely uncommon nowadays- I am a dentist working in the UK. A body called NICE makes guidelines on the matter- nowadays I dont touch a wisdom tooth unless it has given at least 2 episodes of pericoronitis, or there is some other pathology present such as a cyst or resopbtion of another tooth caused by the wisdom tooth Ashley Payne 08:16, 25 Mar 2005 (UTC)

This may not be so true in the United States where dentistry is an entirely private industry. Many people I've known have had their wisdom teeth out based on the prognosis that they would impact if they had the chance to continue growing. --Jbaber

I doubt preventative removal is all that common in the USA. I was going to have my wisdom teeth removed until I found out how much it would cost. That is an awful lot of money to remove something that has never given me any problems. Besides, I wouldn't call dentistry in America entirely private considering the tremendous number of state laws telling insurance companies what to cover. - Paul
I beleeeive if you make it to the (U.S.)military and still have them, they'll take them out. Maybe only if you're going to be stationed overseas-- When my wisdom teeth came in, and caused me no problems, my mother agreed that hers hadn't given her any trouble either, but the army insisted on taking them out. Cantras 19:13, 10 December 2006 (UTC)

As I understand it, wisdom teeth removal is more rare in the UK than the USA. In the USA, it is often preventive, whereas in the UK it is to fix a problem. 68.49.142.108

Just a small note that I made a new "impactions" section and moved three paragraphs from the leading text there, and reorganized impaction types by how common they are, and explained that sorting in text. I think that change now appears as much larger than it was in reality in the history due to the moving, so I hope I didn't scare anyone. ;-) -- Jugalator 21:40, 15 December 2005 (UTC)

28 teeth

I have 28 teeth. Nothing unusual about that. Except what I thought were my wisdom teeth arrived in my late teens/early twenties - they did the whole erupting-through-gums thing that wisdom teeth are supposed to do.

All my teeth (except for one of these recent interlopers which is a bit wonky) are perfectly straight and healthy, and there are no gaps. I've never needed dental work. On the mandible I have four incisors, two canines, four premolars and four molars. Same for the maxilla.

So where have my missing teeth gone? ;-) --HiddenInPlainSight 18:55, 3 February 2006 (UTC)

Maybe they are hiding!!! ;) Well, if you have had a pan lately and there are apparently no third molars, then it is good you are one of those people who have them missing and do not have to deal with them. - Dozenist talk 22:16, 3 February 2006 (UTC)

WIsdom teeth keep growing?

I'm 35 years old and my dentist told me that the wisdom teeth may keep growing even at this age, actually a growth spurt may affect the other teeth adversely. Having experienced the complications of extraction in my relatives, I rather prefer to keep them as long as possible (one has a small cavity that will need to be filled, two are standing irregular, but they don't hurt). To the dentists reading this - do such "growth spurts" at my age really happen? Or are they just trying to talk me into something? --84.115.129.76 10:13, 9 May 2006 (UTC)

Dentist911's edit.

Dentist911 added the following line:

Odontophobia is the fear of dental surgery and a surprising number of people have the fear/concern that after their wisdom teeth are removed, they will no longer possess as much intelligence as they once did. Although such an idea would usually be considered ridiculous, there is evidence to support this claim.

This statement is very unclear, and if there's evidence, we need a reference. Do you mean evidence that some people fear that removal of wisdom teeth will cause them to be dumber? If that's the case, I don't know if that's relevant, since there are tons of crackpot theories out there, but maybe I'm wrong. On the other hand, if you mean "there is evidence to support that removal of wisdom teeth makes you dumber," then we DEFINITELY need to see some references for that.

Anyway. Lastly, this was added to the "impactions" section. That doesn't seem to be a very good fit there. Perhaps it could be reduced to a sentence in the opening intro? You could also create the page odontophobia - seems like there isn't one right now. SnowFire 05:05, 12 May 2006 (UTC)

Operculum

I have done my homework but am not entirely confident about my recent edit. Is an operculum considered an, or part of an, impaction? Is it a type, or part, of soft tissue impaction? I believe it's neither, but may be wrong. — Preceding unsigned comment added by Stereo (talk • contribs) 02:41, 10 June 2006 (UTC)


Etymology

The previous Etymology reinterated the common misconception in the Netherlands that the Dutch word derives from 'far-standing molars', and that the English word is a mistranslation of this word. Even in the Netherlands this is nothing more than folk etymology. —Preceding unsigned comment added by 210.84.61.67 (talk) 03:16, 9 August 2006 (UTC)

Sickness from pulled teeth?

A friend of mine is having a get-together soon and another friend of mine says he may not be able to make it because he might still be sick. He says he's sick from having his wisdom teeth pulled. Two questions--How does having your wisdom teeth pulled make you sick, and is it normal to HAVE wisdom teeth at 15 years old? --Kiwi 10:46, 10 August 2006 (UTC)

1) Your friend could be sore from the actual procedure, but he could be sick from the medication. 2) At 15 years of age, a wisdom tooth is usually not in the mouth, but it may be impacted. Usually, the wisdom teeth are formed during that age, see tooth development. Of course, for your particular friend, though, who knows. Those are just some ideas. - Dozenist talk 15:26, 10 August 2006 (UTC)
a) Your friend could quite possibly be suffering from nausea as a result of the anesthetic administered during his extraction surgery. b) It is completely "normal" to possess wisdom teeth at such an age. By then, I would imagine they had not yet erupted, though. They're probably still buds, or have started to grow some small-medium sized roots. - NTK

OPG

I do not agree with the diagnosis in the caption under the orthopantomogram showing impactions. There is no way to tell if the upper right wisdom tooth is impacted from the radiograph. It may be normally erupted with a distal angulation. The same can be said for the lower right (however this is clarified in the caption). While this would not really affect Joe Soap reading about his impacted wisdom teeth, a dental student reading this would end up mildly confused, methinks. I vote for change to ignore the right side altogether, or at least to clarify that the diagnosis of the right wisdom teeth was made clinically. Dr-G - Illigetimi nil carborundum est. 16:33, 31 October 2006 (UTC)


Gum recovery question

I was wondering whether or not the gumline heals to its original shape after removing a wisdom tooth that had not erupted. In my case, it has been a little more than 3 months after an excruciating removal, where the dentist removed much of the rear gum line on my top right jaw. Now what I have is a deep groove where my gums should normally be, and food often gets stuck back there now. A minor annoyance, but an annoyance nonetheless, which I hope will clear up if the gums do heal.

Yes, I agree with this. I had a lower wisdom tooth removed and it left a substantial dip / gap behind the second molar. My tongue now feels strange against the back of the second molar and the gap is very evident to me. Indeed, my mouth does not feel comfortable anymore. I would do anything to get that tooth back, roll on tooth regeneration and I would do it. I am of the opinion that the removal of wisdom teeth is often pointless. If a person has a larger jaw, then why should these pefectly functional teeth be seen as a nuisance.

One does not have to have them removed. They go to the dentist and they have x-rays done and the dentist can monitor your wisdom teeth. The only reason he/she would recommend removal would be because it is causing a cyst, an infection or the patient has complained of pain. If my wisdom teeth had come in perfectly and not have been impacted there is no way in hell I was going to put myself through what I just put myself (2 days ago I had all of my wisdom teeth surgically removed). I do recommend getting them taken out if they are going to cause problems in the long run!!

I am having mine removed in two separte surgeries. I have already had teh first two removed (from my left side) the top is healed up fine. There was a flap and some puss for a few days with some hydrogen peroxide and my tounge I manged to remove the puss and force the flap to heal in place. The bottom on the other hand was a different story. Earlier on it was the easier one, but now it has the gap in it and food gets stuck in it. The surgery itself was paied for by the provence (low income family) but anesthetic was not. So I had to only have basic freezing, though that wasn't so bad. The top tooth only needed a standard extraction while the bottom one needed to be cut out. In a couple days I'll be going in for the second set. Kc4 23:54, 15 December 2006 (UTC)

Early Loss of Molars Theory of Wisdom Teeth

Absolute rubbish. Use of refined carbohydrates in the diet has only appeared in the most recent 5% of human evolution, and has not been around long enough to effect an evolutionary change. Evidence of this is borne out in DMFT studies of indigenous populations. As has been previously pointed out the correct theory relates to shortening of the jaws over an evolutionary period. I will remove this. The cited reference is a website of dubious quality, IMO. Dr-G - Illigetimi nil carborundum est. 23:21, 28 January 2007 (UTC)

Numbness

Another thing after the surgery that a patient can experience is numbness. It is normally temporary in younger patients, but may be more likely to be permanent in older patients. Permanent numbness can occur because of the closeness of the wisdom teeth to the nerve. 71.250.35.162 22:33, 12 August 2006 (UTC)

Apart from some numbness being due to the anaesthetic, wouldn't a damaged nerve be a consequence of a poorly executed extraction by the dentist, rather than a side effect of removed wisdom teeth that sits close to a nerve? Proximity of a tooth to a nerve should be inconsequential if an extraction is performed well, shouldn't it? --IanUK
Well, I guess there are a various number of situations that may occur during an extraction, but some things have to be done with a best guess. It is sometimes difficult to be 100% certain where a nerve is in relation to a tooth. A nerve can run right beside a tooth, or creates an indentation through a tooth, or even runs directly through the roots of a tooth. Especially in the cases where the nerve tunnels through a tooth, it is extremely difficult to avoid damage to the nerve during an extraction. - Dozenist talk 14:39, 22 September 2006 (UTC)
I think the effect on the nerve has more to do with how extensive the growth is. If the wisdom teeth have taken root in the underlying jaw, there will be more trauma to the nerve and possibly even damage. If the teeth are extracted before they have fully grown into the mouth (at a younger age), they are further from the nerve and long or even short term damage should be minimal. My surgeon pointed out that my roots had not yet grown into the underlying jaw and so the risk of damage would be minimal. Calsolt 05:34, 29 March 2007 (UTC)

Fixing the wrong problem?

The problem with the wisdom teeth is that there is no room for them because we don't lose our teeth anymore. Instead of the extreme measure of removing them, why don't we remove one of the existing molars to let the wisdom tooth grow in? I'm obviously missing something. -- Myria 08:50, 21 December 2005 (UTC)

--I guess because it is unlikly that the wisdom tooth will bridge the gap, it may or may not move in to a degree, but you will typically have an annoying gap in between your teeth which food will get lodged in.

I also do not see why it would be less extreme to extract a perfectly healthy tooth that is functioning normally and has time to develop fully as opposed to extract a tooth in its developing stages. - Dozenist talk 03:28, 3 January 2006 (UTC)
I think that they mean removing a different molar earlier on, when it starts to grow in, so that there will be room for the wisdom tooth. An interesting idea, but then you'd have to go for a few years with a giant space back there, and, as said before, they might not take up enough space to fill the gap. --Linktoreality 03:34, 7 January 2006 (UTC)
Not to mention the fact, as noted in the tooth development article, third molars (aka wisdom teeth) are absent in 20 - 23% of the population. That would be a bit of a disappointment if you believed another tooth would replace the tooth extracted, but as it turns out you are in that 20 - 23%. Anyways, I think taking the third molar out really is the best solution even if you could somehow be assured that the third molar would come in. Third molars, especially mandibular (lower) ones are the most likely to have an odd shape and deep grooves, so they would be more prone to decay. Endodontic (root canal) treatment would likely be more difficult since root shapes of third molars are usually very curved. And even if everything previously mentioned was discounted, there is still a problem that the third molar would not erupt into the mouth in a nice position. It would be a bit posterior... further back in the mouth, and though it would drift forward, it could very well have a steep tilt to it, which make for a food trap, greater chance for decay, and make it more difficult for the teeth to bite properly together. - Dozenist talk 06:10, 7 January 2006 (UTC)
I think the big reason we wouldn't remove the molars instead of the wisdom teeth is because the molars have already finished growing into the mouth and integrated with the underlying nerves. The wisdom teeth, on the other hand, are often pulled out before they have finished development and growth towards the nerve. In short, removing a fully grown tooth would be many times more traumatic to the jaw bone, gums, and nerves than removing a half developed wisdom tooth. Removing molars is probably more likely to cause permanent damage to the underlying nerves than removing wisdom teeth. Calsolt 05:40, 29 March 2007 (UTC)

I want to know...

1) What % of people develop wisdom teeth 2) For what % of these are they problematic (requiring extraction)

Good call. Also, there needs to be information on which countries commonly practice extraction. I'm reasonably sure that it isn't done in the whole developed world. Esn 04:29, 21 December 2006 (UTC)
I would also like to know what problems are supposed to occur if teeth are left behind. I can't seem to find any information explaining this. Kc4 19:45, 25 May 2007 (UTC)
I Just found a great source on this, should be included in article. Kc4 19:49, 25 May 2007 (UTC)

Why don't dentists use stitches

I just had my wisdom teeth removed and my dentists just gave me gauze. Why didn't they stitch me up? My dad told me when he got his wisdom teeth removed he got stitches so i'm somewhat confused.

Sutures are sometimes used, but it is the dentist who decides if they are needed. Sometimes they are, sometimes they are not. If the tissues appear that they will heal quickly on their own, then a dentist may decide not to put any sutures. - Dozenist talk 11:28, 29 July 2007 (UTC)

Advice

Someone should really write some stuff on what to do when you get wisdom teeth coming through. How much is it supposed to hurt before you see a dentist? How long until they should be ok?

I dunno. Mine seem to have started coming in. The one on the right is fine, the one on the left started aching yesterday :(
just had the bottom two that were both growing to the right taken out in less time than it took for the anesthetic to work its magic with what looked like an over-engineered screwdriver! i went to the dentist _before_ it hurt badly :P when my teeth and gums hurt or felt weird when they were coming through in the first place i rinsed with salty water and massaged them with my tongue. and took care of my teeth. here endeth the lesson. 20060310
I dunno. I went to the dentist about a month ago and they said that they could take them out, though they don't know if they will be problems or not. I decided on waiting until there are noticeable problems to get them out, I don't want to go through an unnecessary surgery. They just, within this past weekend, started hurting, but I'm assuming that's what they normally do. When it becomes impossible to focus on anything other than the pain, I think I'll have them checked out. 65.189.170.90 02:26, 16 September 2007 (UTC)

Time(s)

How much time do wisdom teeth usually take to erupt?

Also, my operculum is detached for the second or third time; I'd like some info on this, i.e.:

Vestigial?

How can wisdom teeth be classed as completely Vestigial as they are in the article when if they erupt normally they are as useful as any other teeth? It is my understanding that Vestigial means all most or completely useless. 86.20.26.239 21:43, 29 September 2007 (UTC)

Suggestion

This article could be enhanced by removing the reference to creationism, or perhaps giving this section a heading such as “folklore.” 168.187.119.60 (talk) 10:49, 17 November 2007 (UTC)ARG168.187.119.60 (talk) 10:49, 17 November 2007 (UTC)


I agree. To expose it as what it is, I've put in my own bit of rubbish too. Now, either both lots of nonsense go, or my (admittedly completely spurious) nonsense stays. I'll leave it to someone else to make the decision Fionnmatthew (talk) 21:29, 17 November 2007 (UTC)

Gene Expression

Clearly this article was written by dentists used to viewing wisdom teeth as a disease! Can we please make this less of a medical textbook and more of an encylopedia by including the questions people typically want answering:

  • Is there a "gene" for wisdom teeth?
  • How is it expressed? (i.e. Why at this late stage of life when nothing else is happening much?)
  • Is this really an example of modern human evolution? (Please take care over your sources! This sort of thing has a lot of myths running around and Creationists lurking to pounce)

http://www.helsinki.fi/science/dentgen/bg.html might be a good start and has a link to a tooth gene database.

http://www.medicine.org/general_health_resources/the_wisdom_of_wisdom_teeth indicates that there are two genes involved.

-GM Pink Elephant 04 January 2008 —Preceding comment was added at 12:51, 4 January 2008 (UTC)

mispastement

There's an apparently mis-pasted line in the treatment controversy section, beginning "sensation on the anterior 2/3 of the tongue...".

Mine are bursting through as we speak. It's a b!tch. I'm not going to get it removed, but I hope its done and over with soon.

-G

Good for you. Mine started giving me grief when they first came through but settled after a week and are now all through. That was after a quack dentist charged for a single tooth xray when a whole mouth one was free on health care. Dork. I'm glad the report indicates 60% of extractions could be avoided. —Preceding unsigned comment added by 203.161.104.34 (talk) 08:27, 26 June 2008 (UTC)

Born Without Any

I was born without any wisdom teeth at all existing in my mouth, is there a name for that? --Frenrir1 (talk) 07:18, 11 May 2009 (UTC)

What do you mean exactly? Were you born without wisdom teeth in your mouth or that they haven't they develop in your mouth? Nohomers48 (talk) 03:35, 19 May 2009 (UTC)
Me too. This sentence is contradicted by the wikilink: "Absence of one or more wisdom teeth is an example of hypodontia." THe article on hypodontia specificies an exclusion of wisdom teeth from the definition. Noloop (talk) 18:48, 20 July 2009 (UTC)

Dead link report

Refernce 5 is a dead link.--Excaliboor (talk) 23:30, 27 September 2009 (UTC)

  • This is why when citing a web source that including the date of access is necessary. Below is the cited page, preserved by archive at the Wayback Machine Internet Archive from the 16th of January, 2007.
http://web.archive.org/web/20070116124305/http://www.umanitoba.ca/outreach/wisdomtooth/wteeth.htm

71.165.132.175 (talk) 21:13, 30 October 2009 (UTC)


Percentages

Add percentages, perhaps broken down by ethnic group, of

  • people who were never bothered by their wisdom tooth/archive 1
  • people who were never bothered by their impacted wisdom tooth/archive 1

etc. Jidanni (talk) 01:48, 26 January 2010 (UTC)

Move to singular?

Shouldn't this be at wisdom tooth? 84.203.34.101 (talk) 02:11, 26 January 2010 (UTC) wisdom teeth are gross looking. —Preceding unsigned comment added by 205.155.207.230 (talk) 18:34, 3 February 2010 (UTC)

Proto-Humans and other primates ?

The article focuses on wisdom teeth with respect to modern humans...
Do other primates have molars that emerge years later than the other "adult" teeth, or do all the "adult" teeth emerge ( roughly ) simultaneously ?
86.25.123.248 (talk) 16:48, 28 May 2010 (UTC)

Post-op Tea Bags

I had a wisdom tooth pulled today and was browsing through wikipedia about it afterwards. I added a citation for the tea bag suggestion as it did help me, as the bleeding has gone down a lot since then. I'm not sure if the site I cited is the best as it doesn't mention what helps with the bleeding but a lot of places do recommend it (Google for "wisdom tooth tea bag"). I added the cite as at first, without a citation I was skeptical of it, but I followed up and found lots of recommendations. —Preceding unsigned comment added by 124.169.84.58 (talk) 10:26, 28 May 2009 (UTC)

Tea contains tannin, not tannic acid, as mentioned in all three articles. The tannin page does mentions cicatrizant properties, but without a source, and my best result after a quick Google is Men's Health which, though better than some random post-op recipe, is not that good, and of restricted access. Perhaps someone with more tooth wisdom can fill in both here and at Tannin? :P Chemtox (talk) 19:42, 1 April 2010 (UTC)

I don't know how to do the citing but I found a mention of it in here "http://www.webmd.com/oral-health/guide/wisdom-teeth" if you scroll down a bit you can find it. As for the legitimacy of WebMD vs something like a scientific paper I will leave it up to you guys to decide. —Preceding unsigned comment added by 75.168.110.57 (talk) 08:41, 25 June 2010 (UTC)

Ethymology

Apparently it seems to be attractive to add even more foreign words to the description. It getting a bit messy. Also, I am not sure how to prevent the claim that we owe the name to the Dutch East India Company from entering the ethymology section. It says that its a folk ethymology, but some still felt like adding that we might owe the word to seafaring dutchmen. Australnaut

This is getting over-done, I think. The Languages box on the left provides Wisdom Tooth in numerous languages; the role of this article is not to be a dictionary. Should we agree to remove the Etymology section altogether, moving the English etymology to the introduction, and deleting the foreign translations? Cap'n Refsmmat (talk) 03:50, 10 July 2010 (UTC)
I agree: remove the Etymology section altogether, and move only the English etymology to the introduction. Mitch Ames (talk) 12:32, 10 July 2010 (UTC)

Was just wondering, how do wisdom teeth relate to seafaring Dutchmen? Kielbasa1 (talk) 19:31, 18 September 2010 (UTC)

Repeated Vandalism

Hi, the intro states that "Wisdom teeth usually appear between the ages of 17 and 25" and provides a source from the AAOMS to back this up. Despite this, the anonymous user 68.50.110.203 continually reverts this to ages of 17 to 21. As per Wiki Policy, any fact on this page has to be backed up by a source. As the source specifically states 25, his continued editing constitutes vandalism. This has happened at least 5 times now. If anyone notices this user, please revert his non constructive edits. Thank You.Flygongengar (talk) 16:54, 17 December 2010 (UTC)

Added definition

I added two brief sentences to the intro explaining what impaction and eruption are. Its hardly perfect but when i tried reading this article there was no explanation of either and made the subject unclear, Perhaps a new section before impaction should be title eruption as that is presumably what happens to most wisdom teeth and would make this article much more clear. Could also add the likeliness of eruption/impaction occuring. 114.76.41.165 (talk) 02:29, 28 February 2011 (UTC)

I removed the definition, and made the link to impacted specific to dental impaction. If that's not enough, extremely concise definitions could be added to the "Impaction" and "Partial eruption" sections. --Ronz (talk) 03:28, 28 February 2011 (UTC)
The link was already there, but under dental impaction it has "see wisdom tooth"... 114.76.41.165 (talk) 08:38, 28 February 2011 (UTC)
Yes, it's more circular than I'd like. I was thinking of expanding it a bit.
What do you think of just adding very concise definitions at the beginning of the two sections rather than the longer definition in the introduction/lede? --Ronz (talk) 17:04, 28 February 2011 (UTC)
I think that would be the best approach, but I don't really mind so long as it is provided at some point. Ideally I would like to see a short section on eruption as it seems that only complications are discussed rather than what happens in I imagine are a majority of cases. 114.76.41.165 (talk) 11:51, 2 March 2011 (UTC)

Wisdom Teeth Growing Back

I had four wisdom teeth out and they all grew back in the same place. How common is this? — Preceding unsigned comment added by 89.100.37.108 (talk) 23:20, 20 July 2011 (UTC)

Healthy wisdom teeth?

This article seems to focus almost entirely on the removal of wisdom teeth. Is there nothing to be said about healthy, unimpacted wisdom teeth? I'm sure I'm not the only person whose third molars fit. Also, people who lose teeth due to dental problems in their teenage years can quite benefit from the extra teeth. This relates to the vestigiality section, which fails to mention that there are plenty of other reasons that humans prior to the age of good dental hygiene could have stood to benefit from the appearance of a few extra teeth. Feeeshboy (talk) 04:03, 8 April 2010 (UTC)

It would seem logical that it was quite frequent for people to lose teeth in premodern times, so that wisdom teeth could sometimes tighten things up and partially compensate.
In any case, it would probably be best for the non-pathology stuff to go first, and for the wisdom teeth problems sections to be grouped together more towards the end of the article... AnonMoos (talk) 21:55, 20 August 2011 (UTC)
I have the same gripe with this article I think it is very biased towards extraction. I also have wisdom teeth that have come in, that "fit" and are perfectly healthy. I have 2 more which are in the process of emerging. I favour keeping wisdom teeth if they are healthy. Other than cosmetic reasons, if they are healthy I can see no benefit to actually removing them. — Preceding unsigned comment added by 188.223.49.106 (talk) 23:22, 20 August 2011 (UTC)

Dry socket

Wisdom_tooth#Dry_socket says that "A dry socket is a painful inflammation of the alveolar bone", however the results of a quick google seach (example, another example) suggests that inflammation is not a defining characteristic - only exposure of the bone is. However, I am not a dentist. Perhaps someone with more direct knowledge could verify or fix this. Mitch Ames (talk) 00:16, 20 May 2010 (UTC)


The medical term for dry socket is alveolar osteitis, and the suffix "itis" means "inflammation." See Mayo Clinic online for details, and note that the definition centers around the patient's experience of severe pain: http://www.mayoclinic.com/health/dry-socket/DS00778 Meticuliz (talk) 16:53, 23 September 2011 (UTC)

Treatment controversy -- NYT September 5, 2011: "Wisdom of Having That Tooth Removed"

http://www.nytimes.com/2011/09/06/health/06consumer.html?ref=todayspaper

"Numerous comprehensive reviews of research, conducted by independent bodies not affiliated with oral surgeons, have concluded that there was no evidence to support routine prophylactic extraction of impacted but healthy wisdom teeth." — Preceding unsigned comment added by 99.190.133.143 (talk) 03:23, 28 October 2011 (UTC)

Biased source

The American organization which says that the instance of nerve damage for prophylactic wisdom tooth removal is "extremely low" does not have a neutral point of view, and yet an answer directly from their web site is being presented as if it were fact.

There is nothing on that site stating the number of cases of nerve damage from this surgery whatsoever. This surgery is a multi-billion-dollar industry in the USA.

If no one can substantiate the fact that instance of nerve damage is "extremely low" when the wisdom teeth are extracted before the formation of roots from a site that is not so obviously biased, I am going to remove this statement. 173.162.248.49 (talk) 18:05, 24 February 2012 (UTC)

Reads like a dentist's advertisement

There is very little discussion of how common it is to have wisdom teeth, and how often wisdom teeth pose no problems if left alone. Nor is there adequate discussion of how often extraction is necessary when they do pose problems.

Some lip service is paid to it in the "controversy" ghetto, but in the end the discussion of the "controversy" is equivocating and unclear.

As a whole, the article conjured up the image of an eager, pushy dentist insisting that, "Yeah, buddy, wisdom teeth are a huge problem! It may not seem like it, but it's bad - trust me, I know these things - I mean, would I lie to you? We'll have to do an extraction, but don't worry! Here, just sign your agreement to all these expensive medical procedures..."

No offense meant to the contributors. At least the discussion of the pathology is extensive. — Preceding unsigned comment added by 209.200.34.100 (talk) 22:26, 3 September 2012 (UTC)

Vestigial structure

I don't think there's really any question that wisdom teeth constitute vestigial structures. However, there is perhaps controversy. [1] [2] The first of the linked references is an anti-evolution website arguing that wisdom teeth are not evidence of evolution but are instead the result of some sort of change in the genetics of the human population that somehow isn't actually evoltuion, and the second source argues that wisdom teeth are evidence of evolution. I imagine the conclusion of the latter of these two sources has more proponents and should thus be more represented in the article. I'm going to try to make the article less weasely by citing these sources, although I realize this could be a genesis for an edit war. Theshibboleth 12:47, 24 September 2006 (UTC)

I'm fairly surprised to learn that the "wisdom teeth" (also known as molars) that I've had for more than a decade and have been using to grind food nearly daily since then are, in fact, "vestigal", which means that they "have lost all or most of their original function in a species through evolution" (from the wikipedia page). I can guarantee that they have NOT lost their function. In fact, they function just as well as the other molars which I have. What isn't in question is that more than one dental worker has attempted influence me into routine unnecessary surgery for removal of asymptomatic wisdom teeth. So I think that's why there are people who want to say that there "really isn't any question" that wisdom teeth are "vestigal" -- it's an excuse to coerce people into unnecessary surgery and thus increase profits for unethical dental workers. The fact that lay people repeat this conventional "wisdom" is sad. Loundry (talk) 14:49, 11 January 2008 (UTC)
My biology dictionary (Henderson's 13th, ISBN 0-131-27384-1) defines "vestigial" as "of smaller and simpler structure than corresponding part in an ancestral species" and/or "small and imperfectly developed". No mention of being non-functional, but sadly this does not help as then we have to decide if they're underdeveloped! I'd suggest though that we might be looking at it the wrong way. Since the size of the jaw seems to be the predominant factor, maybe we should regard number of teeth like the length of our arms, continuous rather than discrete. That negates the need for an argument over whether they are vestigial. The issue is why our jaws have shrunk - probably in line with an easier cooked diet. GM Pink Elephant —Preceding comment was added at 22:37, 26 January 2008 (UTC)


  • "If the bleeding lasts for more than a day without decreasing despite having followed the surgeon's directions, the surgeon should be contacted as soon as possible. This is not supposed to happen under normal circumstances and signals that a serious problem is present."

It mentions a "serious problem," yet there is no description. If it's serious, shouldn't we get to know what it is?

I think this should be removed, as it a 160 yr old racist belief. Darwin's Descent of Man clearly states that wisdom teeth are a problem solely because of a western diet, are not a problem "in the melanian races" due to their diet, and uses this as a proof that Western man is more evolved than their brown cousins. So wisdom teeth are only vestigial if you believe the brown man is a subrace of humans? yes/no? Charles Darwin, The Descent of Man, and the selection in relation to sex (London: John Murray, 1871) p. 26-27 — Preceding unsigned comment added by 67.186.44.158 (talk) 09:42, 23 January 2013 (UTC)

Symptomatic and asymptomatic wisdom teeth

The article uses the terms 'symptomatic' and 'asymptomatic' to describe wisdom teeth a few times - what do these mean in that context? Is it just whether or not the molar will push against other teeth when it emerges? — Preceding unsigned comment added by Rikeus (talk • contribs) 03:43, 11 February 2013 (UTC)

assume symptomatic means causing symptoms, such as pain. Lesion (talk) 19:27, 5 April 2013 (UTC)
that's a great question, in England (from what I understand) under NIH friends have told me it two episodes of pain is a criteria for extraction. Is a 10mm pocket with bleeding and communication to the impacted tooth "symptomatic" if it doesn't hurt. Ian Furst (talk) 19:16, 8 April 2013 (UTC)
That was from the NICE guidance from 2000, which stated that a second episode of acute pericoronitis was generally considered reasonable indication for extraction. If the first episode of pericoronitis is severe, they also recommended extraction rather than wait for a second episode. That was just related to pericoronitis, pain may of course be related to other pathology, and there are several other indications for extraction...and yes some of these may be painless processes... cysts, decay, resorption, periodontal disease etc were also listed. I think what I'm trying to say is that in the UK, a wisdom tooth doesn't have to have caused pain twice to be worth the taxpayer's money so to speak. I think the majority of oral surgeons ignore the "2 episodes of pericoronitis" rule and just use their judgement in each case.
If we look at the cochrane review cited in this article, it has this to say: "An impacted wisdom tooth is called trouble-free if the patient does not experience signs or symptoms of pain or discomfort associated with it (Song 1997). The literature also uses the terms 'disease-free' and 'asymptomatic' (Shepherd 1993)." I personally think we should take "symptomatic" = causing symptoms and "asymptomatic" = not causing any symptoms, rather than complicate things with health care economics. In answer to the original Q, if the wisdom tooth gets pushed up against another tooth (tooth impaction), this is not the same as symptomatic, since impacted teeth can be without any symptoms. Lesion (talk) 20:59, 8 April 2013 (UTC)

Purpose of wisdom teeth

It is redundant to say the purpose of wisdom teeth because scientist know why they exist in humans. They exist because our ancestors had wisdom teeth as do all other apes besides humans. Perhaps discussing the current trend for the frequency of humans without wisdom teeth being discussed (though this might not be an issue of evolution since all animals have variation, and the lack of wisdom teeth isn't an adaptation but just a variation that is being discovered with more and more people finding dental care or it could be evolution as I have discussed above though wisdom teeth will probably not disappear from humans without a change in our societal structure). Martin 198.133.139.5 18:48, 18 April 2007 (UTC)

That is so wrong. Read Tinbergen's four questions. Plus this part of the article: "For nonbehavioral aspects of biology (e.g., anatomy), three of the four questions are applicable. Only the proximate mechanism is not relevant, as it cannot be an explanation for itself." You're only talking about the proximate explanation, and have removed the ultimate explanation. Thank you for editing Wikipedia. --Bernard Marx 21:54, 8 June 2007 (UTC)
Not entirely, if you had read the above discussion post, you would see that evidence from the fossil record does not support the "early loss of molars" theory. It quite simply didn't happen over a long enough period to affect an evolutionary shift. Tinbergens's questions do not address the amount of time required to affect an evolutionary change, only the proposed mode of action. Also they are philosophically theoretical, not a set of provable theorems. This article requires an evidence base to support statements, and whilst the university of manitoba website is a source of moderate quality, please try and back up your claims with citations, if you wish to replace the offending material. Also please read above discussion. Thank you for editing wikipedia. Dr-G - Illigetimi non carborundum est. 15:36, 15 June 2007 (UTC)
Also, normal variation is a quite acceptable description of wisdom teeth, in many humans wisdom teeth are functional and do not contribute to pathology, and in many they are nonfunctional, unerupted, impacted or cause other problems. Genetic heterogenicity has been suggested as a reason for the lack of space for wisdom teeth, as expressed by a discrepancy between jaw size and combined tooth size. Tinbergen's questions may be applicable in this situation, but again, there it is not correct to say that wisdom teeth are vestigial as in many humans they play a normal functional role.Dr-G - Illigetimi non carborundum est. 15:41, 15 June 2007 (UTC)
I was just saying that Martin's reason for removing that statement was (in my opinion) totally wrong. I think you'd agree that "because our ancestors had wisdom teeth" is not a sufficient explanation as to why we have wisdom teeth.
In fact, I was quite surprised to see that the article has this much material on extraction and treatment and does not even attempt to provide an explanation for the origin of the wisdom teeth. I think that's a major omission, and when I saw that there used to be a sentence addressing that point, which was backed up by "a source of moderate quality", (and which was removed for incorrect reasons), naturally I re-inserted the material.
My only concern is the lack of attempt to address the question of the origin of the wisdom teeth. You seem knowledgeable on this subject (certainly more knowledgeable than I am), could you write a short section on it please? --Bernard Marx 21:36, 15 June 2007 (UTC)
Seems to me that the origin of wisdom teeth is not so worrisome. The opinion goes that ancient homonids, with a diet considerably different than what we are accustomed to now, had longer jaws which presented a greater total surface area of molar (accommodating the third set fully) with which to grind their food -- the 'purpose' of wisdom teeth. Jaw size aside, their eruption in later life (20-30 is 'later' when the average lifespan is unlikely to reach 40) might be apropos to replace teeth lost or broken during their adolescent or young adult lives. So, over three million years, give or take a weekend, we have develped pronouncedly shorter jaws, but the DNA which codes how many teeth to grow in the mouth hasn't changed (except in anomalous circumstances). The teeth are there because they have always been there - "because our ancestors had them". The point which seems to want addressing is: what evolutionary pressures (more specifically than merely "a changing diet") favored - or pressured - the devlopment of this shorter jaw? - Tenmiles 04:39, 16 June 2007 (UTC)
This is all assuming you believe in evolution, a theory which is always presented as fact. — Preceding unsigned comment added by 165.228.63.179 (talk) 02:20, 27 June 2013 (UTC)

Some People don't get em'

You need to put this in your article!!!!--Mary Di Valerio 15:13, 10 September 2007 (UTC)

The first sentence of the article states: "Wisdom teeth are third molars that usually appear between the ages of 16 and 24 (although they may appear when older, younger, or may not appear at all)." In any event, I am curious about the percentage of people that do not have wisdom teeth. · jersyko talk 18:58, 10 September 2007 (UTC)
Tooth_development#Abnormalities claims that "[t]he absence of third molars [occurs] in 20–23% of the population", but doesn't give a reference. Pjrm (talk) 03:59, 23 January 2010 (UTC)
Under Vestigiality and variation we need some real English language words to replace jargon like agenesis so real people can actually understand what they are reading. Kortoso (talk) 23:10, 6 December 2013 (UTC)

Wisdom teeth evolution

Humans are gradually losing their wisdom teeth, with some individuals having them congenitally absent.

I understand that this is cited but it's absurd to suggest that humans are evolving to lack wisdom teeth. It doesn't have a high enough mortality rate to have an effect on the evolution of man. Further more, the fact that some people are born without them doesn't prove anything either way, some people are born with 6 fingers doesn't mean humans are evolving to have 6 fingers. I have removed this statement until better support is garnered. Wolfmankurd (talk) 00:45, 14 January 2010 (UTC)

In the past 10k years we've gone from everyone getting wisdom teeth to only half of us. (http://www.timesonline.co.uk/tol/news/uk/article592250.ece) That's lightning speed on an evolutionary scale.
Your assumption that wisdom teeth do not affect reproductive fitness must therefore be wrong. I can see two causes. 1) Maybe now and in Western countries treatment is excellent, but in less civilised circumstances there's a real possibility that a wisdom tooth can kill before the age of 30. 2) Even tiny differential fitness can have a big impact when aggregated over the generations.
Of course, we're now entering the age of the genome, and before long we'll be modifying our dna to choose the colour of our offspring's hair, the number of their teeth and even their teeth's colour for all I know, so basically all bets are off now. But that has nothing to do with wisdom teeth per se.
82.139.87.74 (talk) 04:39, 21 July 2010 (UTC)
The fact that we have moved away from wisdom teeth over the past 10,000 years does not mean that the same evolutionary pressure remains to this day. Wisdom teeth clearly have far less impact on your survival than they did a thousand or more years ago. The sentence quoted above would be more accurate if it states that humans have gradually lost some of their wisdom teeth over the past ten thousand years, rather than suggesting that the process is still underway. The sources do not support the latter assertion. Cap'n Refsmmat (talk) 16:00, 21 July 2010 (UTC)
We don't have data on how many people had wisdom teeth 10,000 years ago. Kortoso (talk) 23:14, 6 December 2013 (UTC)

Cochrane Review discussion

copied from user talk page
Hey Badgettrg, wasn't sure if you follow wisdom teeth so I thought I'd leave a message here re the page. I'm concerned your last edit,

"The Cochrane Collaboration has published a systematic review of randomized controlled trials [emphasis added] in order to evaluate the effect of preventive removal of asymptomatic wisdom teeth. "Insufficient evidence was found to support or refute routine prophylactic removal of asymptomatic impacted wisdom teeth in adults" according to the Cochrane Collaboration"

is misleading.

Because of the emphasized sentence preceding the quote from the article, my conclusion (and I believe most people reading the paragraph) will be that there was RCTs available, but the data didn't show any benefit or harm. Rather than, there were no RCT's. I thought I'd contact you here, in the hopes of building a consensus, rather than just making the change, as this tends to be a contentious topic. Thoughts? Ian Furst (talk) 14:39, 24 December 2013 (UTC)

Oops. Yes, I should not have used my generic Cochrane line. Feel free to revise. Thanks. Robert Badgett 16:10, 24 December 2013 (UTC)
Cochrane conlusions are very carefully worded. There is a difference between a "lack of evidence of efficacy" (i.e. we couldn't find any evidence) and "evidence of a lack of efficacy" (i.e. we found evidence which said X didn't work). Lesion (talk) 17:38, 24 December 2013 (UTC)

there's been another reword of this sentence by Wordsmith17 to,

The Cochrane Collaboration conducted a systematic review of the published data on removal of asymptomatic impacted wisdom teeth.[12] They determined that there is not enough evidence to support either the routine removal or retention of asymptomatic impacted wisdom teeth

My opinion is that this is misleading and (basically) takes it back to the previous version. I realize that the sentence is consistent with the actual sentence from the study, but without the context of the conclusions (or the sentences that follow it) a layperson would have difficulty making sense of it. Here are the main results,

No RCTs were identified that compared the removal of asymptomatic wisdom teeth with retention and reported quality of life. One RCT on adolescents was identified that compared the removal of impacted mandibular wisdom teeth with retention and only examined the effect on late lower incisor crowding. This study at high risk of bias provided no evidence that extraction of wisdom teeth had an effect on lower incisor crowding over 5 years.

Somewhere, in the review of the Cochrane study it should be mentioned that, while they conducted a systematic review of the literature, they could find no publication that were applicable to the study question. Because this is a contentious issue, I've posted the topic here for discussion rather than just reverting. Interest to hear what others' think. Ian Furst (talk) 21:44, 28 December 2013 (UTC)

This new wording (by a colleague of mine) is correct and different from the original wording that was criticized. The original said that a review of RCTs was done: that would imply to many people that multiple RCTs were reviewed (not just that they looked for, and intended to review, any trials they could find). So the new wording is different, and it is accurate. There's a problem with saying, though, that the trial is not relevant to the study's question. The inclusion of a trial means that they considered the trial relevant. It is arguable whether or not this was an appropriate judgment call: their inclusion criteria list a very specific of outcomes, and this trial doesn't include any of them. Indeed, it seems more likely that this was a problem with their original inclusion criteria - removing wisdom teeth in people in the belief that it will prevent crowding is a common reason for removal of wisdom teeth. So whether you believe that the trial should not have been included, or the inclusion criteria should be different, it remains so that the authors of the review considered the trial relevant enough to not exclude it. Hildabast (talk) 21:19, 3 January 2014 (UTC)

@Hildabast:@Badgettrg:@Lesion:@Wordsmith17:

Hildabast, I'm trying to build consensus here through a discussion of the study, rather than just making more changes to the statement on the page. To declare your (or your colleague's) wording as the "correct" version goes against wikipedia consensus. I would ask your indulgence in the discussion, rather than a summary dismissal of my point. The primary rationale for extraction cited by the study was to prevent pathology such "as inflammation of the gums around the tooth, root resorption, gum and alveolar bone disease, damage to the adjacent teeth and the development of cysts and tumours." It then went on to say, "Other reasons to justify prophylactic removal have been to prevent late incisor crowding." The primary result was that, "No RCTs were identified that compared the removal of asymptomatic wisdom teeth with retention and reported quality of life." The second result was, "One RCT on adolescents was identified that compared the removal of impacted mandibular wisdom teeth with retention and only examined the effect on late lower incisor crowding. This study at high risk of bias provided no evidence that extraction of wisdom teeth had an effect on lower incisor crowding over 5 years." My opinion, is that they found 1 (highly biased) study to answer the secondary question (e.g., is there evidence prophylactic extraction prevents anterior crowding, a theory that has long since been debunked) and no RCTs to answer the primary question (e.g. does prophylactic removal result in lower long-term morbidity). I have no argument with the Cochrane group including the investigation on crowding. My suggestion remains, that we should include a second sentence (or maybe a third) about the lack of studies included in the review. How about,

The Cochrane Collaboration conducted a systematic review of the published data on removal of asymptomatic impacted wisdom teeth. They could find no RCTs to include in the study with respect to the development of pathology (infection, damage to adjacent teeth, cysts, tumours) later in life. They found one (highly biased) study which provided no evidence that the extraction of wisdom teeth results in lower incisor crowding. The Cochrane group concluded that there is not enough evidence to support either the routine removal or retention of asymptomatic impacted wisdom teeth due to the lack of appropriate studies.

Personally, I think it's too long a summary of this investigation (given that they only found 1 study) but I'm trying to find a middle ground that helps interpret this study for the layperson. Ian Furst (talk) 00:39, 4 January 2014 (UTC)

I don't know what is best here. This, from the MEDMOS sounded like it might be significant:
...so maybe we shouldn't talk too much about the review itself. In cases like this where wording is disputed, it might be best to directly quote from the source... Lesion (talk) 01:46, 4 January 2014 (UTC)
I'd be good with that too, assuming everyone is comfortable with quoting more than the 1 sentence so that there is some perspective.Ian Furst (talk) 03:06, 4 January 2014 (UTC)
The methodology of a systematic review actually does require that reviewers stick to the methods they describe prospectively - most especially their inclusion/exclusion criteria. That's what makes it a 'systematic' review, rather than just a review. Statements from other sections of a systematic review discussing the background, do not substitute for this. For Cochrane: "In Cochrane reviews, questions are stated broadly as review ‘Objectives’, and specified in detail as ‘Criteria for considering studies for this review’. The review question should specify the types of population (participants), types of interventions (and comparisons), and the types of outcomes that are of interest. The acronym PICO (Participants, Interventions, Comparisons and Outcomes) helps to serve as a reminder of these. These components of the question, with the additional specification of types of study that will be included, form the basis of the pre-specified eligibility criteria for the review." (Cochrane Handbook, ch 5) In terms of quoting from the review: agree that will transmit the findings of that review accurately, but it won't necessarily be easy to understand. The use of the word "correct" I won't apologize for: it was precisely what I meant. For the language of systematic reviews, that was what those words mean. (I raised that she was my colleague in case someone may regard that as a COI.) Whatever else though, please don't say that "the Cochrane group concluded." The review conclusions are those of the authors, not of the Cochrane group. Hildabast (talk) 04:39, 4 January 2014 (UTC)
OK, if you'll allow me, let's hit the reset button on this discussion. 1) I appreciate the review on methodology from someone of your expertise and the fact that you'd participate on wikipedia 2) I'm a seasoned clinician in this field with an academic bent and am not completely ignorant of the power (and potential for error) in these studies 3)Wikipedia is intended for the layperson but commonly used by clinicians - our goal is to bring the information to the masses (in an understandable way); something I think we can both agree on? My concern is that, "They determined that there is not enough evidence to support either the routine removal or retention of asymptomatic impacted wisdom teeth", while accurate, does not provide enough context. Is your objection to paraphrasing the investigations results? Do you have an alternate suggestion? My personal opinion, is that the inclusion criteria was too broad and the one study included should have been excluded because it's outcome was late incisor crowding, not pathology - but that's a debate for a separate area, not Wikipedia. Also, happy to remove the reference to the Cochrane groups conclusion - originally it said, "the investigation concluded..." but then got switched around. Ian Furst (talk) 13:47, 4 January 2014 (UTC)
If I understand your discussion above Ian, you would rather specifically say that no RCT met the inclusion criteria instead of "there is not enough evidence", which could be vague in comparison? I tend to agree with Ian's point that this might be slightly more transparent for readers, although I would not use this exact wording suggested 2 posts above. If I understand Hilda's post, we should also add the qualifier "authors" instead of saying "the cochrane group concluded".
Yes, another place could be here, Ian: http://www.ncbi.nlm.nih.gov/pubmed/22696337 (If you can't self invite into PubMed Commons, you can contact me over my SciAm blogpub.) Yes, I found the way they used impacted etc potentially confusing. But I've lost track now of what's proposed, though. Could you cut and paste it again please? Hildabast (talk) 15:14, 4 January 2014 (UTC)

How about this, "The Cochrane Collaboration conducted a systematic review of the published data on removal of asymptomatic impacted wisdom teeth. They could find no randomized controlled trails that compared the removal of asymptomatic wisdom teeth with retention and reported quality of life. One (highly biased) trial on adolescents was identified that compared the removal of impacted mandibular wisdom teeth with retention and only examined the effect on late lower incisor crowding. The authors concluded that there is not enough evidence to support either the routine removal or retention of asymptomatic impacted wisdom teeth." Trying to strike a balance between plain language and scientific language here. Ian Furst (talk) 15:55, 4 January 2014 (UTC)

The "highly biased" wording could be problematic. If this has come from the review authors, we should make this clear. They probably said "Judged to be at high risk of bias" or something? Lesion (talk) 17:03, 4 January 2014 (UTC)
Yep, liking this. The italics are additions: "A systematic review of the published literature could find no randomized controlled trials that compared the effects of removal of asymptomatic wisdom teeth with keeping them. One trial in adolescents who had orthodontic treatment comparing the removal of impacted mandibular wisdom teeth with retention was identified. It only examined the effect on late lower incisor crowding and was rated 'highly biased' by the authors. The authors concluded that there is not enough evidence to support either the routine removal or retention of asymptomatic impacted wisdom teeth." It's common for people to say "The Cochrane Collaboration" or similar did a review, but this is just a journal, and the authors do the reviews - they are not endorsed by the whole organization. We tried to reduce people doing this from early on by calling that section "authors' conclusions," but it's an uphill battle. Calling it a Cochrane review is correct - so is "authors/reviewers from the Cochrane Collaboration/relevant Cochrane group." Hildabast (talk) 17:38, 4 January 2014 (UTC)
Now that we are making it clear that thew review said highly biased and it is not a Wikipedia editor, happy with this wording too. Interesting comment re cochrane not endorsing these reviews. Would have thought that cochrane would simply not publish any review that hadn't been carried out according to their guidelines... that must count for some level of endorsement? Lesion (talk) 18:04, 4 January 2014 (UTC)
No, not for the Cochrane Collaboration. Cochrane isn't one thing: it's just over 50 different groups who produce reviews within their scope, each with their own rules and their own approaches to the central rules. They vary enormously. And many of the decisions are highly contested. Cochrane has been putting a lot of effort into creating central standards and trying to improve adherence to them, and documented some of the large variation in practice - as have many of us who do methodological and standards work for systematic reviews generally. I think of it as 50+ 'journals' collected under one banner. Some reviews are highly divisive even within the group that published it, and even more so between groups. But the reviews' conclusions are those of the authors. Hildabast (talk) 18:20, 4 January 2014 (UTC)

Will make the changes to the article. Thank you for the input. Very interesting how the Cochrane collaboration works, I'd understood it to be a group from the UK that had a highly standardized means of conducting the reviews - it never dawned on me there was that much variation. I was the senior author on a systematic review back in 2000 and the methodology was very stringent imo. At the time, the term was uncommon but now it seems basic literature reviews are tagged with a similar "systematic review" even though the inclusion process is often overly-broad and the comparisons poorly structured. Does pubmed enforce a single standard before listing something as a "systematic review"? Ian Furst (talk) 19:23, 4 January 2014 (UTC)

change made, please give a read to confirm. Thx. Ian Furst (talk) 19:31, 4 January 2014 (UTC)
Thanks! Yes, there are many misconceptions about Cochrane. PubMed doesn't have a publication type systematic review. We are curating systematic reviews of healthcare interventions via PubMed Health - of which Cochrane are a decreasing minority - and including systematic reviews that come from agencies like NICE and aren't in PubMed journals, and ones that are in journals inside or outside PubMed that are identified in DARE. So it's roughly the DARE criteria. It's explained at PubMed Health. Doesn't mean it's a good systematic review though - neither is a Cochrane review necessarily good. Here are the PRISMA reporting standards. Hildabast (talk) 21:45, 4 January 2014 (UTC)
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