Symptoms of Impacted Wisdom Teeth and Treatment

Impacted wisdom teeth can cause various oral problems. Today's article will describe the causes of this condition and available treatments.
Symptoms of Impacted Wisdom Teeth and Treatment

Last update: 20 August, 2021

The third molars, commonly known as wisdom teeth, are the last to grow in the back of the mouth. But what happens when a dentist diagnoses them as “impacted”?

In general, third molars erupt in the posterior sector during the period at the end of adolescence through early adulthood — between 17 and 25 years of age. However, there are times in which the molar doesn’t make it through the gum and can’t come out. Thus, it’s totally or partially trapped underneath and we refer to it as an impacted wisdom tooth.

Today’s article will describe how this condition can occur and also its symptoms and complications. You’ll also read about how dentists treat this problem.

Characteristics of impacted wisdom teeth

As we mentioned above, the wisdom teeth are the last to erupt at the back of the arch of the mouth. There are four molars in total: two upper and two lower ones on both sides.

The thing is there’s often no space for them to emerge and so they’re stuck and results in an impacted wisdom tooth.

Furthermore, there’s no apparent sign of it even coming out in some cases. In others, only part of the tooth may erupt but part of the crown remains under the gum while some of it is exposed in the oral cavity.

Symptoms of impacted wisdom teeth

Some of these are asymptomatic and patients will only learn about them after a dentist’s diagnosis. The following symptoms do manifest in other cases, however:

  • There may be pain in the area where the molar is stuck or discomfort in the ears and jaw.
  • Swelling of the jaw, an enlargement of the area where the impacted molar is located — this is common when there’s an infection.
  • Food remains between the tooth and the gingival tissue that covers it when the molars are partially impacted (a part of the tooth comes out while the rest remains under the gum). Thus, it makes dental hygiene difficult and so bacteria and food accumulate under the gum. It often causes inflammation, pain, and foul odor.
  • The gums become swollen, red, and bleed.
  • There’s foul breath and bad taste.
  • Finally, there’s difficulty opening the mouth.

Consult a dentist if you have any of these symptoms as they may be due to impacted wisdom teeth.

A woman with a toothache.
Pain due to impacted wisdom teeth is due to inflammation.

Causes of impacted wisdom teeth

The main cause of impacted wisdom teeth is the lack of space for their normal eruption. The molar stays inside the bone because there’s no room for it to erupt.

The retention may be total and the tooth remains inside the bone and doesn’t go through the gum at all. Partial retention happens when some of it remains inside the bone.

Another reason for this alteration could be an incorrect alignment of the tooth inside the bone, which prevents eruption. This is because the molar will run into other anatomical structures that won’t allow it to erupt into the mouth by growing at the wrong angle.

For example, if the molar is arranged horizontally or obliquely, the growth will run into the second molar that’s in front of, or against the back wall, of the mouth. The third molars may be inward or toward the cheeks or completely upside down. These abnormal arrangements make correct eruption impossible and give rise to retention.

Some factors increase the risk of impacted wisdom teeth. Being between 17 and 25 years old and having a small lower jaw, for example.

Diagnosing impacted wisdom teeth

The diagnosis of an impacted third molar happens through a dentist after a clinical examination which may include X-rays. They also take the reported symptoms and manifestations they observe while exploring the oral cavity into consideration.

X-rays confirm the presence of the tooth retained in the bone. In addition, they reveal any lesions there may be in the teeth and surrounding bone tissue.

Treatment

This depends largely on whether or not there are symptoms and these affect a person’s quality of life.

Asymptomatic teeth

There are times when this condition doesn’t cause any inconvenience but they can choose from two alternative approaches:

  • Expectant management. Dentists with a conservative approach recommend controlling impacted teeth and leaving them in the oral cavity. Their reasoning is a tooth that’s not causing problems doesn’t require surgery. There’s always the option of extraction if future problems arise.
  • Preventive extraction. Some professionals recommend the extraction of retained teeth to prevent potential problems. They do so to avoid future complications.

There’s not enough evidence or research to support either position though.

Painful teeth

The dentist will extract the impacted molar if it causes any bothersome symptoms. This type of surgery is an outpatient procedure performed in the dentist’s office and lasts between 30 and 60 minutes.

The oral surgeon, after anesthetizing and sedating the patient, cuts the gum and removes the bone covering the molar during the procedure. Then, they remove the tooth, whole, if possible, or in fragments, as the case may require. They then stitch the wound and cover it with gauze.

The professional will indicate any necessary postoperative actions to promote healing such as rest, cold compresses, anti-inflammatory drugs or antibiotics, and a soft diet to properly recover and prevent complications.

The patient should go back to the dentist so they can remove the stitches and check the wound a week after surgery. Slight bleeding, pain, bruising and swelling in the area, and difficulty opening the mouth are common manifestations after impacted wisdom teeth surgery.

Moreover, alveolitis, infections, injuries to neighboring teeth, jawbone, nearby nerves, sinuses, or temporomandibular joint are less frequently associated complications and require immediate attention.

In addition, consult a doctor ASAP if there’s severe pain that doesn’t go away or numbness or paralysis of the tongue, or problems breathing.

A man at the dentist.
There are two approaches to impacted wisdom teeth: conservative or surgical treatment.

Get the proper Care After Getting Your Wisdom Teeth Pulled

Complications of impacted wisdom teeth

Impacted wisdom teeth make oral hygiene difficult as food debris becomes trapped and bacteria begin to proliferate in the area. Overall, they can cause some of the following problems:

  • Difficulty keeping the back of the mouth properly sanitized. This favors the accumulation of bacteria and food debris. This is a predisposing factor for the development of cavities in these teeth.
  • The bacteria that accumulate between the tooth and the gum can lead to infections and abscesses.
  • Also, the pressure exerted by the impacted tooth can lead to crowding and overcrowding of the other teeth. Thus, orthodontic treatment, in addition to the extraction of wisdom teeth, will be necessary to solve this problem.
  • Damage to other dental elements when the impacted wisdom tooth generates pressure against the second molar. This is because it can affect the tissues, causing inflammation, resorption, or mobility of this neighboring tooth. It also leads to infection in the area and can compromise nearby teeth.
  • The molars still inside the bone are surrounded by a sac and the persistence of this structure can lead to liquid accumulation and form a cyst that can in turn damage the maxillary bone, teeth, and nerves. In addition, it can evolve into a tumor. Extirpation is necessary and requires the removal of part of the bone.
  • The accumulation of bacterial plaque in the area due to the difficulty of brushing properly promotes the inflammation of the gingival tissue.

Some dentists recommend the extraction of impacted wisdom teeth, even if they’re not causing any symptoms, due to the possibility of said complications.

Early dental visits are essential

There’s no way to prevent an impacted wisdom tooth. However, visiting the dentist every six months will allow you to monitor the growth and appearance of these molars. Overall, regular dental appointments ensure the monitoring and early detection of any oral problems you might have.

Impacted molars can alter a person’s quality of life, but they can also go unnoticed. Some cases need no treatment but others require surgery to solve any problems they cause or to prevent them.

The recommendation is to take action as soon as possible when in need of extraction of impacted wisdom teeth. Surgery is usually less difficult in young patients as the roots aren’t yet fully developed. However, the long, curved roots and compact rigid bone can complicate extraction in adults.

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