Impacted Wisdom Tooth Removal

We have three sets of molars, the wisdom teeth being the furthest back and the last to come in. The wisdom teeth are no longer used whereas our ancestors needed them to be able to chew their food. They often remain impacted below the gum line in modern humans. Our third molars typically come in between the ages of 16 and 25 years and are often removed to prevent problems in the future. It is not uncommon for them to be extracted early in anticipation of orthodontic treatment.

The wisdom teeth develop in the jaw perpendicular to the rest of our and need room to rotate and push through. If a patient has the space in their jaw for the wisdom teeth to fully erupt, they may not need to be extracted at all. The only time an impacted wisdom tooth needs to be removed is if it is actively causing a problem, has the potential to cause a problem in the near future, or is in the way of orthodontic work.

Types of Tooth Impaction

There are different ways that a tooth can remain impacted in the mouth. They include:

  • Mesial impaction: the tooth is angled too far toward the front of the mouth, the most common type of impaction.
  • Distal impaction: tooth is angled toward the back of the mouth
  • Horizontal impaction: the tooth is lying on its side, as wisdom do
  • Soft tissue impaction: the tooth has pushed through the jawbone but remains covered by the gum tissue
  • Bony impaction: the tooth remains embedded within the jaw bone

Extracting Impacted Wisdom Tooth

If your dentist believes that your wisdom teeth need to be removed, they will likely refer you to an oral surgeon. The oral surgeon will perform their own exam and make a determination about extracting your wisdom teeth. At this visit, it is important to ask any questions that you may have about tooth extractions and what to expect.

Your oral surgeon will discuss anesthesia and together you will decide what type is best for you. Most extractions can be done with a simple local injection at the site but some require general anesthesia, during which the patient is asleep. You may also be given the option to take a sedative, like valium, that will help you relax during the procedure.

After extraction, the site is sutured with dissolving stitches that generally do not need to be removed by the doctor since they will dissolve on their own. The doctor will provide post operative instructions as well as pain medication and an antibiotic to prevent infection.

Impacted teeth can lead to more severe problems down the road. Untreated, impacted wisdom teeth can cause the other teeth to shift out of alignment and change your bite, which can be uncomfortable and cause additional issues. Additionally, the impacted tooth can develop decay which can spread to healthy teeth. If you dentist advises wisdom tooth extraction, it is in your best interest to proceed with treatment.

Tooth Impaction Symptoms and Treatments