Impacted Wisdom Teeth

Impacted wisdom teeth are common in teens and adults. The human jaw is often not large enough to fully accommodate this third set of molars. This means the teeth often fail to fully erupt into the mouth. They may remain stuck in the jaw bone (bony impaction) or never emerge fully through the gums (soft tissue impaction). In addition to being covered by gum or bone tissue, these molars are often positioned at an angle toward the front of the mouth so that the second molar is in the way of the emerging tooth. Occasionally, they may also be angled back toward the ear or horizontally in the jaw.

In some cases, the crown of the wisdom tooth may actually press up against the root of the second molar. This can contribute to serious problems like tooth crowding and resorption of the second molar’s tooth root. Even wisdom teeth that emerge partway through the gums may still cause recurring oral health issues such as gum inflammation or infection. Wisdom teeth that are partially impacted (with some of the crown showing above the gum line) are difficult to keep clean. This can increase the incidence of both periodontitis and cavities in the third and second molars.

Are Impacted Wisdom Teeth a Cause for Concern?

Not all impacted wisdom teeth go on to create oral health problems. In fact, they may remain asymptomatic throughout your life. However, these teeth do at least need to be monitored since not all problems that damage the nearby second molars cause noticeable symptoms at first. This monitoring can be done via x-ray at your yearly dental visit. You should report any changes around your third molars such as inflammation, soreness, tenderness, jaw pain, tooth crowding or other symptoms to your dentist right away. Bear in mind that the longer you wait to have impacted wisdom teeth removed, the more challenging the procedure tends to be.

What Should I Do About Gum Inflammation from Partially Impacted Wisdom Teeth?

For some patients, the main problem with a partial soft tissue impaction is gum inflammation from a flap of gum tissue partly covering the crown of the wisdom tooth. Here, food debris can become trapped and bacteria can thrive. The chronic inflammation that results is called pericoronitis. The gum tissue can become swollen and painful and may ooze pus. You may choose a gingivectomy (gum surgery) to remove this flap of tissue. This sometimes resolves the problem for good. In other cases, the gum tissue will simply grow back. There’s no way to tell in advance whether the treatment will be permanent.

What Is the Treatment for Impacted Wisdom Teeth?

Surgical removal is the only real fix for impacted wisdom teeth. This extraction procedure involves making an incision in the gums to reveal the tooth. Depending on where the tooth is located and how many roots it has, the tooth may need to be cut into smaller sections for removal. A bony impaction may involve opening up the jaw bone to access the tooth root. However, if part of the crown has emerged through the bone, it is often possible to simply remove the molar in pieces through this exposed area.

This treatment is almost always an out-patient procedure. It is done under a local anesthetic along with nitrous oxide or an oral sedative depending on the extent of the surgery and the patient’s preference. If you closely follow your post-operative instructions, particularly when eating, your chances of avoiding post-operative complications like dry socket are high. An uncomplicated recovery takes several weeks as the gum gradually heals. The bone itself takes many months to fully heal and fill in the now empty socket. However, the discomfort is usually minimal after the first few days. The risks associated with impacted wisdom teeth are eliminated by removal. They don’t grow back; so once you have this surgery you don’t have to worry about your third molars any more.