Impacted wisdom teeth are a common dental issue that occurs when the third set of molars, located at the back of the mouth, do not have enough space to emerge or develop normally. This can lead to the teeth becoming trapped within the jawbone or gums, causing pain, swelling, and potential infection. If left untreated, impacted wisdom teeth can result in significant discomfort and complications, affecting overall oral health.
Wisdom teeth are more prone to tooth decay. The surrounding areas are a haven for bacteria, which can lead to plaque buildup, which in turn can lead to diseases and a host of related issues. While not always the case, having wisdom teeth removed is often necessary if they are impacted. Dental experts from the American Association of Oral and Maxillofacial Surgeons provides guidelines for the diagnosis and treatment of impacted wisdom teeth.
Causes of Impacted Wisdom Teeth
Lack of Space
The jaw may not have enough room to accommodate the extra set of teeth, leading to impaction.
Abnormal Angles
The wisdom tooth may grow at a wrong angle, such as toward other teeth or the back of the mouth, causing them to become impacted.
Overcrowding
The wisdom teeth may lack sufficient space to erupt properly.
Genetics
A family history of impacted wisdom teeth can increase the likelihood of experiencing similar issues.
Developmental Anomalies
Some individuals naturally develop wisdom teeth that fail to emerge properly due to developmental issues.
Understanding these causes can assist in early detection and treatment, helping to prevent more severe problems associated with impacted wisdom teeth.
The Main Red Flags
Pain and Discomfort
One of the earliest and most common signs of impacted wisdom teeth is a persistent ache or sharp pain. This can range from mild to severe and often worsens with chewing or pressure on the area.
Swelling and Redness
The gums around an impacted wisdom tooth that did not erupt properly may become swollen, tender, and red. This inflammation can make it difficult to clean the area properly, increasing the risk of infection.
Jaw Stiffness
Impacted wisdom teeth can cause throbbing and stiffness in the jaw. This can make it difficult to open the mouth fully, speak, or chew, and may even affect daily activities.
Bad Breath
The area around an impacted tooth can become a breeding ground for bacteria and tooth decay, leading to chronic bad breath. This condition, known as halitosis, can persist even with regular brushing and flossing.
Unpleasant Taste
Infections or drainage from an impacted tooth can cause an unpleasant taste. This taste may be metallic or sour and is often accompanied by a bad odor.
Headaches
The pressure from impacted wisdom and other teeth, can radiate to other areas of the head, leading to headaches. This pain can be persistent and may be mistaken for tension or migraine headaches.
Swollen Lymph Nodes
Infected wisdom teeth can cause the lymph nodes under the jaw to swell. These swollen lymph nodes may be tender to the touch and can indicate that the body is fighting an infection.
Understanding these symptoms can help in recognizing impacted wisdom teeth early and seeking appropriate treatment, thus preventing more severe complications and maintaining overall oral health.
Types of Impacted Wisdom Tooth
Mesial Impaction
This is the most common type of impaction where the wisdom teeth are angled forward toward the front. The crown of the wisdom tooth points toward the adjacent molar, leading to partial impaction.
Distal Impaction
The third molar is angled backward toward the rear of the mouth, with the crown pointing away from the second molar. This positioning can be more challenging for oral surgeons to treat.
Vertical Impaction
In this case, the last molar is upright but partially erupted beneath the gum. The teeth are in the correct position but lack the space to fully emerge, resulting in partially impacted wisdom teeth.
Pulp Vitality Tests
Tests such as thermal tests or electric pulp tests help determine the health of the dental pulp. These tests can distinguish between reversible and irreversible pulpitis.
Horizontal Impaction
A severe type where the horizontally impacted wisdom teeth lie beneath the gum, with the crown pointing directly toward the root of the nearby teeth, often the next tooth.
Soft Tissue Impaction
The crown of the partially impacted wisdom tooth has penetrated through the gum tissue but has not fully erupted. This leads to discomfort, infection, and other symptoms.
Bony (Hard Tissue) Impaction
The third molars are encased within the jaw bone, either partially or fully impacted, requiring oral and maxillofacial surgery for tooth removal. Maxillofacial surgeons often perform this procedure to ensure complete extraction and to prevent potential issues such as periodontal disease, trapped food, and other debris.
Diagnosis
- Symptoms: Pain, swelling, gum infection, bad breath, or difficulty opening the mouth.
- Signs: Tenderness in the back of the mouth, inflammation, and signs of infection.
- X-rays: Panoramic X-rays or periapical X-rays to determine the position of the impacted teeth and assess their relation to adjacent structures.
- CBCT: Cone-beam computed tomography (CBCT) may be used for a more detailed 3D view if needed.
Management
- Asymptomatic Impacted Teeth: Regular check-ups to monitor if the teeth cause any problems.
- Symptomatic Impacted Teeth: More active intervention is required if symptoms develop.
- Medications: Over-the-counter pain relievers such as ibuprofen or acetaminophen.
- Warm Salt Rinses: Can help soothe gum irritation.
- Antibiotics: Prescribed if there’s an infection present.
- Oral Hygiene: Improved brushing and flossing techniques to reduce risks.
Treatment
Extraction
- Indications: Persistent pain, recurrent infections, damage to adjacent teeth, or if they are causing other dental issues.
- Procedure: Performed by an oral surgeon or dentist. The complexity of the extraction depends on the position of the tooth and its development stage.
- Simple Extraction: For teeth that are fully erupted or partially erupted and accessible.
- Surgical Extraction: For teeth that are impacted, requiring an incision and possibly removal of some bone.
- Partial Removal (Coronectomy): In cases where the tooth is too close to vital structures, such as nerves, a coronectomy may be performed. This procedure involves removing the crown of the tooth while leaving the roots intact, reducing the risk of nerve damage.
Post-Operative Care
- Recovery: Follow care instructions including pain management, oral hygiene, and diet.
- Complications: Monitor for potential risks such as dry socket, infection, or prolonged bleeding.
Alternative Approaches
- Orthodontics: In some cases, orthodontic treatment may be considered to manage the positioning of impacted teeth if extraction is not immediately necessary.
FAQ
How long does it take to recover from wisdom teeth removal?
Recovery usually takes about one to two weeks. Most people can resume normal activities within a few days, with swelling and discomfort peaking within the first 48 hours and gradually improving. Complete healing can take a few months.
Is it necessary to remove impacted wisdom teeth?
Not all impacted wisdom teeth need removal. If they don’t cause symptoms or significant issues, regular monitoring may suffice. However, removal is the best course of action if they cause pain, damage to adjacent teeth, or other issues. A dentist or oral surgeon can advise based on your situation.
What happens if you don’t remove impacted wisdom teeth?
Leaving impacted wisdom tooth untreated can lead to:
- Infections
- Damage to adjacent teeth
- Cysts and tumors
- Pain
- Gum disease
If you’re suffering from impacted wisdom teeth, it’s essential to seek expert care to address the issue effectively. Proper diagnosis and timely management are crucial to prevent complications such as infection, cysts, and damage to adjacent teeth, ensuring overall oral health. Visit Santa Ynez Valley Dental, where Dr. James Morelli, an experienced and skilled dentist, will provide a thorough evaluation and personalized treatment plan. Dr. Morelli’s expertise ensures that you receive the highest quality care to alleviate pain, prevent complication, and promote optimal oral health.