Of course, wisdom molar can be detected just by chance. Let’s try to understand it with the help of case of this 20-year old girl who had come for pain in a badly mutilated (because of dental caries) first molar as you can see in this picture.
A dental radiograph was done to know the condition of roots and associated periapical pathology.
By chance an impacted wisdom tooth was noticed locked underneath the second molar. She never had any trouble ever in the unerupted wisdom tooth area.
What about the future of this ‘locked’ third molar? – it would never come up in the mouth but there would always be a possibility of its causing destruction of now healthy second molar (tooth lying between decayed molar and the wisdom molar) because of ‘pressure’ being exerted over the latter.
The best option for this girl is extraction of the badly mutilated first molar and and the impacted third molar and then getting a fixed partial denture (dental bridge) as a rehabilitation for the first molar.
When i am writing about this, i am reminded of a couple of cases which i have seen during all those years. Suppose what this girl is experiencing at 20years (because of mutilated first molar crown) had she landed upon here at the age of 8 or 9 or 10years or even latter and this tooth would have been extracted at that time, in many such cases it happened in such a subtle way that the second molar migrates mesially to take the place previously occupied by the first molar. Of course in place of second molar, third molar comes up at around 17years or later and person attains reasonably good dental occlusion required for normal chewing. I always get a pleasant surprise when i see such movement of second molar to accommodate wisdom tooth and this surprise is to the extent that i feel like posing a simple question to myself –am i so tolerant and accommodating too?
However, in this girl at 20, such movement of wisdom tooth is almost unlikely and therefore the pro-active approach i have already suggested to the patient.
I wish we screen all the youngsters in 17-21 age group for impacted wisdom teeth — however that seems to be far cry as people hardly come for regular periodic dental check-ups.
I feel it is enough to kick-start this day — Good morning!