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Impacted Wisdom Tooth: Types, Causes, Symptoms, Risks & Treatment

Animated image of person with wisdom teeth

Understanding a wisdom tooth infection is crucial due to the complications it can cause if left untreated.

Knowing the signs and symptoms of impacted wisdom teeth and seeking appropriate treatment from an oral and maxillofacial surgeon is essential for maintaining oral health.

The article will cover the types, causes, symptoms, risks, and treatment options for impacted wisdom teeth. Additionally, it will provide information on wisdom tooth surgery and the role of oral and maxillofacial surgeons in treating impacted wisdom teeth.

What is an impacted wisdom tooth?

It is a third molar that fails to emerge or develop appropriately in the oral cavity for various reasons, such as lack of space or improper alignment of the neighbouring teeth. This condition occurs when the wisdom tooth becomes trapped beneath the gum line or jawbone, unable to erupt fully into its normal position.

Impaction can happen in different ways, including partial impaction, where the tooth partially emerges, or complete impaction, where the tooth remains entirely submerged beneath the gums and jawbone. These can lead to dental problems, including tooth decay at the wisdom tooth region, bleeding gums, infection, and damage to adjacent teeth.

Types of Impacted Wisdom Tooth

Types of impacted wisdom teeth

Here, we will identify and outline the various classifications of wisdom tooth impactions:

Soft Tissue Impaction

This occurs when the wisdom tooth has partially erupted, and part of the surrounding gum is on top of the tooth, preventing it from growing further. It’s the most common type and can lead to sore, swollen gums in the back of your mouth.

Bony Impaction

Instead of being obstructed by gum tissue, bony impaction indicates that the impacted tooth is still covered by the jawbone, usually requiring a more complex and extensive treatment to remove the tooth safely.

Mesial Impaction

A mesial impaction arises when the tooth is angled towards the front of your mouth or is at the wrong angle, which can cause problems for the second molar, leading to overcrowding and even misalignment.

Horizontal Impaction

A horizontally impacted wisdom tooth grows parallel to the jawbone, usually causing pain due to the pressure it exerts on other teeth and the surrounding nerves.

Vertical Impaction

When a wisdom tooth manages to break through the gum line but doesn’t grow straight up, it falls into the category of vertically impacted. This type may be misaligned but is one of the less severe cases of impaction.

Distal Impaction

The distal impaction indicates a wisdom tooth growing at an angle away from the other teeth and towards the back of your mouth. It can lead to pain, crowding, and a failure to erupt fully.

Causes of Impacted Wisdom Teeth

An impacted wisdom teeth

The problem with wisdom teeth often begins at the root—the dilemma is as deep-seated as the teeth themselves. A lack of sufficient space in the jaw is to blame, but there can be additional contributors to oral distress.

Congenital factors

Genetic influences often determine the size of our mouths and the potential for accommodating wisdom teeth.

Abnormal tooth development

Sometimes, a wisdom tooth’s development can be irregular from the start, leading to complications as it grows and becomes a fully impacted wisdom tooth.

Delayed Eruption

Sometimes, the process of wisdom teeth coming in is significantly delayed, which can increase the likelihood of impaction.

Symptoms of Impacted Wisdom Tooth

Girl experiencing pain

Before you call your oral health professional, familiarising yourself with the potential symptoms of an impacted wisdom tooth is beneficial.

Toothache and facial swelling

This is often the most common and easily noticeable sign. The area around the tooth might swell, leading to facial pain and discomfort.

Swelling and redness in the gums

If you notice persistent redness or swelling around the area where your wisdom tooth is trying to emerge, it’s a vital sign of an issue.

Difficulty chewing

Due to the discomfort and lack of proper eruption, you may struggle with chewing and biting.

Bad breath (halitosis)

An impaction can lead to food and debris getting trapped, which can contribute to bad breath.

Difficulty opening your mouth

Known as trismus, this is a condition where your jaw muscles spasm, making it hard to open your mouth.

Swollen lymph nodes

Your lymphatic system may react to the imbalances in your mouth with swollen, sometimes tender nodes.

Fever

An infection around the wisdom tooth could prompt your body’s natural response to fight off the invader, leading to a fever.

Numbness or tingling in the jaw or tongue

When the nerves near an impacted wisdom tooth are irritated, they can send out strange sensations such as tingling or numbness in the jaw or tongue.

Earache

An earache can occasionally radiate to the jaw, causing discomfort that might be misconstrued as an ear infection.

Risks Factors

Extracted wisdom tooth

Before diving into the specific risk factors associated with impacted wisdom teeth, it’s essential to understand the various elements that can contribute to this condition. From genetics to oral hygiene habits, several factors can increase the chances of having to experience wisdom teeth issues.

Let’s explore some of the critical risk factors below:

Infection

The risk of developing an infection with impacted wisdom teeth is significant due to the trapped environment created by their partial emergence. This environment fosters bacterial growth, leading to conditions like pericoronitis, which is marked by gum tissue inflammation and infection.

Untreated infections can result in abscess formation, spread of disease to neighbouring teeth or systemic sites, damage to surrounding structures, and facial swelling. Prompt treatment, including antibiotics and possibly wisdom tooth extraction, is crucial to prevent complications.

Damage to nearby teeth

Pressure from impaction occurs when an impacted wisdom tooth doesn’t have enough space to erupt fully, leading it to exert force on the other teeth.

This pressure can cause several issues:

  • Crowding: Impacted wisdom teeth may push against the teeth adjacent, causing them to shift out of alignment and become crowded. This can lead to bite problems and aesthetic concerns.
  • Damage: The pressure exerted by impacted wisdom teeth causes damage to the roots of the neighbouring teeth, leading to pain, sensitivity, and potential long-term damage to the tooth structure.
  • Resorption: In some cases, the pressure from impaction can cause resorption, where the roots of adjacent teeth are gradually dissolved or absorbed. This can weaken the affected teeth and increase the risk of tooth loss over time.
  • Increased Risk of Decay: Crowded teeth are more complicated to clean effectively, increasing the risk of plaque and tartar buildup, leading to tooth decay and gum disease, further exacerbating dental problems.

Cyst or tumour development

Impacted wisdom teeth sometimes lead to cysts or tumour development in the jawbone. These growths may go unnoticed initially but can cause significant damage if left untreated, including periodontal bone loss and damage to nearby teeth.

It’s crucial to consult a dentist promptly if you suspect any complications with your wisdom teeth to prevent potential cysts or tumour development.

Jaw problems

Impaction can contribute to jaw problems by exerting pressure on the surrounding jawbone and affecting its alignment. When wisdom teeth erupt and become impacted, they may push against adjacent teeth, causing them to shift out of their proper positions. This displacement can disrupt the natural alignment of the jaw, leading to discomfort, pain, and difficulty in biting or chewing.

Additionally, the pressure from impacted wisdom teeth can stimulate the growth of cysts or tumours in the jawbone, further exacerbating jaw problems. Over time, untreated impaction can result in chronic jaw pain, temporomandibular joint (TMJ) dysfunction, and even changes in facial structure due to altered jaw alignment.

Treatment Options

Dental CT Scan

Here are some treatment options available that you can choose after consulting with your dentist:

Pre-operative Consultation and Planning

Pre-operative consultation and planning for impacted wisdom teeth involve several steps to ensure a successful procedure:

  • X-rays: Commonly used to assess the position, orientation, and depth of impacted wisdom teeth. These images provide valuable information to the oral surgeon regarding the location of the tooth, its proximity to adjacent structures such as nerves or sinuses, and the extent of impaction.
  • CT scan (in some cases): CT scans provide three-dimensional (3D) images of the teeth and surrounding structures, offering a more comprehensive view of surgical planning. This is particularly useful for assessing the relationship between impacted teeth and nearby nerves or surrounding bone structures.
  • Discussion of medical history and patient concerns: The pre-operative consultation thoroughly reviews the patient’s medical history, including any underlying health conditions, allergies, or medications. Patients must disclose any relevant information that may impact the surgical procedure or post-operative recovery.

Surgical Procedure

The surgical procedure for wisdom tooth removal typically follows these general steps:

  • Anaesthesia: Before the procedure begins, the patient is administered anaesthesia to ensure they are comfortable and pain-free throughout the surgery. The type of anaesthesia used may vary based on the complexity of the extraction and the patient’s preferences, ranging from local anaesthesia to general anaesthesia.
  • Incision and Access: Once the anaesthesia takes effect, the surgeon will make an incision in the gum tissue to gain access to the impacted wisdom tooth. In cases of a fully or partially impacted tooth beneath the gum line or jawbone, the surgeon may need to remove some bone tissue to gain access to the tooth.
  • Tooth Extraction: The surgeon carefully loosens the wisdom tooth from its socket and removes it from the jawbone using specialised instruments. Sometimes, the tooth may need to be divided into smaller pieces for easier extraction, particularly if it is deeply impacted or closely positioned to adjacent structures.
  • Cleaning and Closure: After the wisdom tooth has been successfully removed, the surgical site is thoroughly cleaned to remove any debris or bacteria. The gum tissue is then sutured back into place to promote proper healing. In some cases, dissolvable sutures are used, while in others, the sutures may need to be removed during a follow-up appointment.
  • Post-operative Care: Following the procedure, patients receive instructions on post-operative care to facilitate healing and minimise discomfort. This may include guidelines for managing swelling and pain, instructions for proper oral hygiene, and recommendations for dietary modifications.
  • Follow-up Appointments: Patients typically schedule follow-up appointments with their oral surgeon to monitor healing progress and ensure proper recovery. During these appointments, the surgeon may remove sutures, evaluate healing, and address any concerns or complications that may arise.

Post-operative Care and Recovery

After wisdom teeth removal, patients can expect some discomfort and swelling, typical after surgical procedures. Here’s what to expect and how to manage post-operative care effectively:

Pain Management: The dentist will provide instructions for managing pain following wisdom teeth removal. This may include taking prescribed or over-the-counter pain medication as directed, typically for the first few days after surgery. Taking medicines as prescribed and not exceeding the recommended dosage is essential.

Swelling Reduction: Swelling after wisdom teeth removal can be managed with various techniques. Putting ice packs on the affected area intermittently during the first 24-48 hours reduces swelling. Keeping the head raised a little while resting can also aid in minimising swelling.

Proper Wound Care: The dentist will provide specific instructions for caring for the surgical site to promote healing and prevent infection. This may include gently rinsing the mouth with salt water or a prescribed mouthwash to keep the area clean. It’s crucial to avoid vigorous rinsing or touching the surgical site with fingers or tongue.

Diet Modifications: Patients should stick to a soft diet for the first few days following wisdom teeth removal to avoid causing problems. This may include consuming smoothies, yoghurt, soup, and mashed potatoes. Staying clear of hard, crunchy, or spicy foods can prevent discomfort and minimise the risk of complications.

Rest and Recovery: Patients need to get lots of rest and avoid extreme activities for the first few days following surgery. Resting allows the body to heal more effectively and reduces the risk of complications.

Follow-Up Appointments: Patients should attend follow-up checkups with their dentist or oral surgeon as scheduled. During these appointments, the surgeon will evaluate healing progress, remove sutures if necessary, and address any concerns or complications.

Monitoring

Monitoring following wisdom teeth removal is crucial in various situations to ensure proper healing and detect potential complications. Patients should closely monitor for excessive pain, persistent swelling beyond the initial 48 hours, or prolonged bleeding, which may indicate issues such as infection or poor blood clot formation.

Signs of infection, including fever, increased pain, or discharge from the surgical site, should be promptly evaluated by a healthcare provider. Difficulty eating or drinking, along with the development of complications such as a dry socket or nerve injury, should also be monitored closely for timely intervention.

Regular follow-up appointments with the dentist or oral surgeon allow for ongoing assessment of healing progress and management of any emerging concerns or complications.

Home Remedies for impacted wisdom tooth

Home remedies for impacted wisdom teeth may be considered when immediate treatment is delayed or unavailable. These remedies aim to alleviate discomfort and manage symptoms temporarily, although they do not address the underlying issue.

Common home remedies include:

  • Rinsing the mouth with water added with salt to reduce inflammation and pain.
  • Apply ice packs externally to alleviate the swelling.
  • Taking over-the-counter pain relievers to manage discomfort.

Natural remedies such as herbal teas, clove oil, or turmeric paste may temporarily relieve pain and inflammation.

However, it’s important to note that while these remedies can offer symptomatic relief, they do not address the underlying cause of the impacted wisdom tooth. Dentists typically do not recommend delaying treatment for impacted wisdom teeth, as doing so can lead to complications such as infection, damage to adjacent teeth, or misalignment of the jaw.

Therefore, seeking professional dental care is essential for correctly diagnosing and appropriately managing impacted wisdom teeth.

Conclusion

In conclusion, impacted wisdom teeth can lead to various dental problems, including pain, infection, and damage to adjacent teeth and structures. Knowing the signs and symptoms of impacted wisdom teeth is essential, as early intervention can prevent complications and promote oral health. While home remedies may offer temporary relief, consulting a dentist for diagnosis and treatment is vital to addressing the underlying cause of impacted wisdom teeth.

Dentists at Casa Dental can provide personalised care and recommend appropriate treatment options, including medication, surgical extraction, or other interventions tailored to the individual’s needs. Individuals can ensure proper management of impacted wisdom teeth and maintain optimal oral health by seeking timely dental care.

FAQs

How do I know if I have an impacted wisdom tooth?

Signs of an impacted wisdom tooth may include:

  • Pain or discomfort in the back of the mouth.
  • Swelling of the gums.
  • Difficulty opening the mouth.
  • An unpleasant taste or odour.

Additionally, impacted wisdom teeth may cause crowding or shifting of adjacent teeth.

Can an impacted wisdom tooth cause ear pain?

Yes, an impacted wisdom tooth can cause referred pain to the ear. Pressure from the impacted tooth can radiate to the ear, leading to discomfort that may be mistaken for an ear infection. It’s essential to consult a dentist to determine the underlying cause of ear pain.

Does the impacted wisdom tooth need to be removed?

In many cases, impacted wisdom teeth require removal to prevent potential complications such as infection, togrilloth decay, and damage to adjacent teeth. However, the need for extraction depends on various factors, including the position and orientation of the impacted tooth, the presence of symptoms, and the individual’s oral health.

How much is an impacted wisdom tooth extraction?

The cost of impacted wisdom tooth extraction can vary based on the type of procedure, geographic location, and whether dental insurance covers the treatment. On average, impacted wisdom tooth extraction can range from a few hundred to over a thousand dollars per tooth.

Should I be worried if my wisdom teeth haven’t come in yet?

While wisdom teeth typically emerge between 17 and 25, some individuals may experience delayed eruption or not develop wisdom teeth. In many cases, delayed eruption is not a cause for concern. However, if you experience pain, swelling, or difficulty opening the mouth, you must consult a dentist for evaluation.

What happens if I leave an impacted wisdom tooth untreated?

Leaving it untreated can lead to complications, including infection, tooth decay, gum diseases, cyst formation, and damage to adjacent teeth and structures. In severe cases, untreated, impacted wisdom teeth can cause significant pain, swelling, and systemic illness. It’s crucial to seek your dentist immediately to address impacted wisdom teeth and prevent potential complications.

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