Most of us have trouble when our wisdom teeth erupt. Whether it is a pain, infection, or a swelling, third molars are known to cause trouble. It is even more troublesome when these teeth are not in their regular position because of lack of space caused by existing teeth and thus called impacted wisdom teeth.

Impacted wisdom teeth require separate management and extraction procedures, which we will read further in this article.

What is impacted wisdom teeth?

The wisdom teeth erupt from seventeen to twenty-five years of age, making them the last teeth to erupt in the mouth. Consequentially, this means that there is a lack of space for them to erupt.

This is because as evolutionary progress, our jaw sizes are getting smaller, and the two molars are the primary functional teeth for chewing, making the wisdom teeth redundant.

Due to this shortage of space, the teeth often erupt tilted, angulated or slightly displaced from their position. Such teeth, which are not in normal orientation and are angled, are called impacted teeth.

Impacted teeth may not be seen entirely in the mouth and may be partially present inside the bone, or entirely in the bone, or even covered by a layer of gums above them. These may be tilted towards the adjacent tooth, or at right angles to other teeth, or even away from the tooth.

An impacted tooth may have only one of its four cusps seen above the gums, or sometimes even one cusp may be just partially visible. The impaction is classified for a better understanding of the dentist, and treatment planning. (1)

Why are impacted third molars problematic?

The fundamental problem for the dentist and us lies in the lack of space and inaccessibility. Since wisdom teeth are located so far behind, it is nearly impossible to keep that area clean with a toothbrush as it reaches with a lot of difficulties.

The inaccessibility increases the risk of decay and gum infections by multi-fold.

Similarly, even for a dentist, to clean the cavity in tilted or partially erupted teeth is difficult as there lies the danger of damaging your adjacent tooth. Apart from this, other problems are lack of vision and instrument reach.

Also, the impacted wisdom teeth may be very close to the second molars that they cover one or more of its surface. Sometimes, even cleaning the second molars or removing a cavity from them is impossible without extraction of the wisdom teeth.

Impacted wisdom teeth symptoms

It is not guaranteed that all wisdom teeth show symptoms. But in cases where they are severely impacted, there are high chances of developing some problems, sooner or later. (2)

Wisdom teeth, during the eruption, have to push their way through the gums. Due to this force, the gums around the teeth get swollen and show increased redness. This is known as localized inflammation of the gums. There may also be bleeding from the gums, accompanied by pain.

Pain is one of the most common symptoms during the eruption of wisdom teeth, and additionally, there may be swelling on the side of the jaw where the tooth is erupting.

This pain tends to worsen as decay sets in, or if the surrounding tooth gets affected, You may also experience a headache, or pain in the entire jaw of that side or rarely, pain that radiates to the ear.

If the infection is widespread, the glands of the neck may also show signs of pain and swelling. Complaints of difficulty in opening the mouth and chewing are not uncommon during the eruption of wisdom teeth.

As we read earlier, infections around that area are common, giving out an unpleasant smell from the mouth, called halitosis. You may also feel like you have a bad taste regardless of what you eat.

Complications of impacted wisdom teeth

We can tell from reading the symptoms of wisdom teeth, that they may come with a set of equally problematic difficulties too. However, with timely treatment, these can be avoided.

Impacted wisdom teeth exert pressure on the gums, causing accumulation of food debris between two teeth and between the gums and teeth. This is the leading cause of periodontal diseases.

Periodontal diseases are the diseases caused in the gums or the teeth socket and bones. One may experience severe bleeding, displacement of other teeth, weakening of the teeth, or receding gums.

Cysts are another complication of impacted wisdom teeth. A cyst is a cavity that is filled with fluid, but not pus. Cysts are common with impacted teeth, hence seen a lot around third molars.

The cyst is most likely to be near or around the roots, and on a radiograph, it appears like a sac. (3) The impacted wisdom teeth cause accelerated decay in the second molar next to it. (4)

Treatment of impacted wisdom teeth

Simply put, impacted wisdom teeth might require removal for getting rid of associated problems. However, extraction of impacted third molars is a complicated procedure which requires a surgical approach.

Once you visit a dentist with an impacted wisdom tooth that is decayed or shows inflamed gums, he/she will run some investigations and get radiographs to know the exact position and angulation of the crown and the roots of the tooth.

The radiographs will show the grade of impaction, the tilt, displacement, and information around any surrounding nerves, tissues or even teeth are at risk. (5)

The surgical procedure requires basic pre-operative preparation, followed by the first step which is making an incision on your gums, to expose the tooth or the bone.

Depending on the degree of impaction, a segment of the bone is drilled, to make space for instruments to remove the tooth from the socket. Also, the tooth is sectioned into smaller fragments that are easier to remove.

The oral surgeon gives sutures on the removal of the tooth and will advise you to keep that area clean and prescribe painkillers and antibiotics for healing.

Side effects, though uncommon, include difficulty in mouth opening, swelling, pain, and the severe complication comprises damage to the nerve. (6)

Over to you on impacted wisdom teeth

It is a matter of time when impacted wisdom teeth begin to bother most of us. It is best to see your dentist on time and have it removed to prevent any complications or problems to other teeth.