Impacted Wisdom Teeth
The third molars, located all the way at the back of the mouth, are commonly referred to as the wisdom teeth. In most cases, people have two wisdom teeth on the top row and two on the bottom. These molars are the last teeth to erupt in a person’s mouth, usually erupting in late adolescence or early adulthood. Because they are the last teeth to erupt, however, it’s often the case that there isn’t sufficient room in the mouth for more teeth. If there isn’t enough room for the wisdom teeth to develop normally or properly emerge through the bone and gums and into the mouth, they may remain trapped in place. These trapped wisdom teeth are known as impacted wisdom teeth, and there are a few different ways that wisdom teeth can be impacted. An impacted tooth might be partly impacted, trapped only partially beneath bone and gums, or fully impacted, snugly in place inside the jaw beneath the gums. An impacted tooth might also appear ready to grow in at an angle, pointed toward an adjacent tooth or toward the back of the mouth, or even at a right angle to the other teeth, parallel to the top of the jawbone. Each of these teeth is an impacted tooth, and any impacted tooth can lead to multiple problems with the dentition and oral health. Even wisdom teeth that aren’t impacted and have grown in properly might cause issues down the road, as the location of the teeth can make it very difficult to keep them clean, making them more susceptible to decay and gum disease.
When impacted wisdom teeth cause pain or complications, these teeth are usually extracted. Whether the tooth is fully impacted or partially impacted, it could cause damage to the other teeth by exerting imbalanced force on adjacent teeth, damaging these teeth, increasing the risk of infection, and crowding or misaligning the other teeth. Impacted teeth can also lead to cysts in the jawbone. Each tooth develops in a sac inside the alveolar bone in the jaw, and, when the tooth doesn’t erupt properly, this sac can fill with fluid and swell, damaging the bone, the teeth, and the nerves. If left untreated, these cysts can develop into benign tumors that can only be removed by removing substantial bone and gum tissue. Partially impacted teeth are also particularly susceptible to tooth decay and gum disease, as their remote, jagged surfaces are often harder to clean, more likely to trap food particles and debris, and more prone to the bacterial buildup that causes tooth decay and gum disease.
There’s no way to keep a wisdom tooth from being impacted, but there’s an easy way to prevent complications: by seeing your dentist for regular checkups and cleanings. At these checkups, your dentist will monitor your wisdom teeth, evaluating their emergence with x-rays and an examination. In some cases, dentists and oral surgeons may recommend extracting wisdom teeth that aren’t causing any issues, with the goal of preventing future complications. If the wisdom teeth have erupted and are properly aligned, your dentist may instead choose to monitor the teeth and the overall health at routine dental examinations, possibly recommending extraction if misalignment, decay, or gum disease appears to be imminent.
Even when they are impacted, the wisdom teeth might not cause any complications, though your dentist can usually determine any potential issues with comprehensive x-rays at your regular dental examinations. When complications do arise, symptoms might include swelling, redness, tenderness, or bleeding in the gums; pain or swelling in the jaw; a bad taste or smell in the mouth; or difficulty opening the jaw. If you experience any of these symptoms, see your dentist for a checkup and x-rays, as they might indicate infection and should be treated promptly. Make sure to follow any recommendations for an oral surgery consultation and treatment, and don’t be afraid to ask whatever questions you might have as you learn more about your impacted wisdom teeth.