ImpactedWisdomTooth.com

Impacted Wisdom Tooth
Types of Impactions
Symptoms and Treatment
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Impacted Wisdom Tooth

Lynne Heckert, DDS, JD

What is an Impacted Wisdom Tooth?

Wisdom teeth are the teeth that come into the mouth last, at age 16-21 (average 18).  Most people get four wisdom teeth, one in the back of each of the four quadrants of the mouth. (But it is not uncommon for a wisdom tooth to be missing and for some people get none.)

An "impacted" tooth is one that is stuck in the bone.  It is ready to come into the mouth but there is not enough room for another tooth.  Impacted third molars are a frequent occurrence, first discovered in  in teens and young adults. These teeth do not completely erupt, remain partially under the gum, and are easy targets for infection.  It is not unusual for teens and young adults to appear in the dental office swollen, unable to open, febrile and in pain when this happens.

Wisdom Teeth Impacted Totally Under the Bone

If wisdom teeth are positioned in such a way that they are totally covered by bone they are often better left alone.  Why?  Because studies have shown more risk in the removal operation of these severe bony impactions than in leaving them in the jaws. These full bony impactions rarely cause infections and, contrary to common and intuitive belief, they do not push other teeth out of alignment.  They can often just sit there peacefully for a lifetime.

When a Wisdom Tooth Erupts Only Partially -- the
Whole Tooth Does Not Fit in the Jaw

When wisdom teeth are partially in the mouth and partially submerged, the gum around them can become infected and inflamed causing swelling in the area around the cheek or down the neck.  This seems to happen more often at exam time or when young patients are under stress.  Under stress, the immune system does not function as well as usual, and in a standoff with bacteria, the bacteria may start to get the upper hand.  The patient makes an emergency visit to the dental office with swelling and pain.   This swelling is called pericoronitis, infection and inflammation  around the crown of the tooth 

The Operculum

Frequently there is flabby gum around the back of the tooth and/or a flap of gum (called an operculum) extending over the biting surface of the  tooth.   Debris and bacteria collect and are trapped under this gum tissue and an infection is the result.  If the tooth is properly erupted and oriented, it may be possible to avoid extracting the tooth by trimming  away the excess gum flap around the back of the tooth (an Operculectomy).

If the tooth is hopelessly submerged and there is no room for it to erupt normally,  the tooth should be extracted. Extraction of impacted wisdom teeth is typically preformed by oral and maxillofacial surgeons (or just "oral surgeons").


SEE DRAWINGS OF IMPACTED WISDOM TEETH



 


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Dr. Lynne Heckert, a general practitioner, has practiced and taught dentistry for over 25 years. More about Dr. Lynne.

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Please remember that information on these site is not all-inclusive and it may or may not apply to your situation and you need to call your own dentist.  A dentist needs to see the tooth, take and x-ray, etc. to diagnose and treat.   I cannot respond to email inquiries or phone calls.  Thanks for visiting!