- An impacted wisdom tooth is a tooth that has not erupted completely. The gum covers it completely or partially, which can cause pain and discomfort.
- Symptoms of impacted wisdom teeth include pain, swelling, inflammation, difficulty with oral hygiene, crowding of the teeth and nerve damage. If left untreated, impacted wisdom teeth can lead to infections, cysts, tumors, and jawbone deterioration.
- There are four types of wisdom teeth: full-bony impacted, partial bony impacted, soft-tissue impacted, and erupted.
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Are you worried that your wisdom tooth may be impacted? Here's everything you need to know.
What do impacted wisdom teeth look like?
Diagnosing impaction could be difficult without dental radiographs. Sometimes, you may be confused if you are experiencing natural discomfort associated with a healthy eruption. This discomfort may resemble the symptoms of an impacted tooth. Meanwhile, you may feel pain even if your wisdom tooth is not impacted.
We differentiate four states of wisdom teeth:
Full-bony or fully impacted
When the tooth is completely stuck in the bone, the removal procedure is often necessary.
Unfortunately, this is also the most complicated situation. A hole will have to be made in the bone, and the tooth will often get dissected into smaller pieces. For those with dental anxiety, it is best to be sedated during this procedure. However, this can significantly increase the final cost of wisdom tooth removal.
Partial Bony impacted
This means that the tooth is partially locked in the bone. The bone surrounding the tooth will have to be broken into smaller pieces. If a partially impacted tooth is left untreated, it can increase a chance of swelling, pain, and oral infections in the future. You may likely need sedation. The longer the procedure, the more anesthesia you will need.
In this case, the tooth is stuck under the gum only. You might experience swelling and pain around the tooth. To remove this kind of tooth, a small incision in the tissue is needed to properly treat the case.
Local anesthetic is often sufficient, but sedation is not uncommon in such a case.
The tooth is not impacted at all. It has broken through the gums and is fully visible. This is a fairly straightforward case, similar to a regular extraction.Reasons for extracting an erupted wisdom tooth are usually overcrowding or other orthodontic aspects.
The procedure of removing an erupted wisdom tooth may take less than 30 minutes. This means that a small-medium amount of anesthetic will have to be used.
An erupted wisdom tooth could be removed by a general dentist. More complicated cases might be referred to a specialist, most commonly an oral surgeon.
Symptoms of impacted wisdom teeth
Symptoms of impacted wisdom teeth vary depending on the type and severity of the impaction.
Pain is one of the most common signs of impacted wisdom teeth. Such a tooth inflicts pressure on the surrounding gums, making them tender. The tooth pushing other adjacent teeth or bones can also cause pain. The pain can radiate to the entire bone, making it stiff and hard to open. It can also spread to your ears or cause headaches.
Impacted teeth may lead to inflammation and swelling in the gums, jaw, and cheeks. They can also push other teeth closer to each other and cause crowding. This painful condition makes oral hygiene more difficult and can affect the appearance of your smile.
Finally, an impacted tooth can even damage a nerve in the jawbone. This can cause numbness in your chin, lips, or tongue.
Causes of impacted teeth
There are several factors that can make your wisdom teeth impacted. Usually, this happens when there is not enough space for a new tooth to grow. Genetic factors can cause such predisposition. Often, their jaws are too small to accommodate all of their teeth. They may suffer from crowding even before a wisdom tooth erupts.
Genetics can also cause abnormal jaw development that affects wisdom tooth growth. Environmental factors, malnutrition, hormonal imbalances, and jaw misalignment have similar effects. Craniosynostosis, or the rare condition of premature fusion of skull bones, also affects tooth growth.
Damage to the jawbone is one more reason for wisdom teeth impaction.
Impacted wisdom teeth complications
The symptoms of impacted wisdom teeth themselves can be severe and affect your health. If left untreated, the infection can occur in the tooth and surrounding gums. Over time, the infection can spread to other parts of the body through the bloodstream. In extreme cases, it can lead to sepsis and other lethal conditions.
Impacted teeth can also lead to cysts, tumors, and jawbone deterioration.
Treatment for impacted wisdom teeth
To choose the best treatment, your doctor will diagnose and analyze the exact impacted wisdom teeth symptoms that you are experiencing.
Mild forms of impaction do not necessarily always cause health problems. Your wisdom tooth may grow at an unnatural angle, but it may also erupt completely and not affect other teeth and tissues.
If you have such an impacted wisdom tooth and there is no decay, your dentist may decide to leave it without treatment. However, you must monitor it and see a doctor if any problems occur.
If your dentist decides to keep your wisdom tooth, but its impaction causes pain/discomfort, you may need an anti-inflammatory medication. This may be an NSAID or a nonsteroidal anti-inflammatory drug. Ibuprofen and naproxen are commonly used NSAIDs. For more severe pain, the doctor may prescribe steroids such as dexamethasone or prednisone. Both groups of medications are effective for reducing pain and swelling.
Additionally, your doctor may prescribe antibiotics to deal with infections.
Your doctor may also suggest taking one of these medications after a dental procedure, such as flap surgery or extraction.
Many dentists prefer to remove impacted wisdom teeth. Still, you can also receive orthodontic treatment if the condition is not severe. You can have treatment with dental appliances such as traditional braces, Invisalign, or palatal expanders. To have ideal results, you will need to wear the appliance for several months or even years.
Your doctor may combine your treatment with distalization or perform this procedure separately. Distalization involves moving your teeth away from the midline of your face. This creates more space in your jaw. Doctors use appliances such as mini-screws, distal jets, or distal shoes for this procedure.
If you suffer from crowded teeth or a narrow maxillary bone, your doctor may perform SARPE, or surgically-assisted rapid palatal expansion. This surgical procedure creates more space for the teeth by separating the halves of the jaw. To achieve this effect, the doctor makes small incisions in your upper jawbone.
Dentists usually perform flap surgery or gingivectomy to expose wisdom teeth hidden under the gums. This procedure is generally performed for soft tissue impaction. However, dentists may also use it for less severe cases of mesial impaction if it is possible to save the tooth.
Your doctor will lift a flap of gum tissue and clean the tooth. The surgeon may also reposition the gum so it can heal properly. This procedure requires anesthesia or IV sedation.
If flap surgery reveals a decayed tooth, your doctor will most likely recommend extraction. This is also a common solution for severely impacted wisdom teeth.
The complexity of the procedure depends on the severity of your condition. Your surgeon may first need to expose the tooth by making an incision in the gum. It may also be necessary to break the tooth into pieces for easier extraction.
Patients undergo IV sedation or local anesthesia during extraction.
Can wisdom teeth rot under gums?
If the gum covering an impacted tooth is damaged, food debris can get stuck there. This can lead to a breeding ground for bacteria. If you have an operculum or gum flap over your impacted tooth, your wisdom teeth are even more likely to rot under the gums.
Can tooth impaction be prevented?
In most cases, it is impossible to prevent the impaction of wisdom teeth. However, sometimes, you can minimize the chances of developing the symptoms. Treating crowded teeth with one of the procedures described in this article is one possible solution. If you can have an early prevention, you may have a chance of preserving a non-impacted tooth.
Can wisdom teeth grow back after removal?
Wisdom teeth cannot grow back. Yet, you may notice a small piece of a tooth in your gum. This is not a new tooth. It is called ankylosis, or the fusion of a small part of a tooth that was left in your jaw with the bone. This condition may require further treatment, depending on the severity.