What is impaction?
Wisdom teeth are not aligned with other teeth all the time. There are different theories as to why they would not just erupt vertically just like other teeth. Even if the widsom tooth is setting vertically, sometimes that is not enough for it to show through and reach occlusion. When a wisdom tooth is not biting against the opposing tooth it is considered impacted.
There are various degrees of that impaction. The tooth might just show through the gums and gets covered partially by the gum, here we say it is partially impacted, or in the other extreme, it might be setting horizontally inside the jaw bone, well buried in the bone.
Problems of Wisdom Tooth
1- When a wisdom tooth is showing though the gums and covered partially by the gums, this flap of gum -called operculum – gets infected repeatedly, because germs keep getting underneath. The condition of the inflamed operculum is called Pericoronitis.The treatment is to keep cleaning underneath, and sometimes give antibiotics. If the condition keeps recurring, then taking out the wisdom tooth is recommended.
2- When a wisdom tooth is fully covered in bone, studies suggest that such tooth might develop a cyst around it which can be precancerous and develop into a tumour. Thus in this extreme, it is recommended to take it out, or at least monitor it with x-rays every year to check for signs of cystic change.
3- The wisdom tooth is just like any other molar can get decayed. Actually the wisdom tooth is more likely to get decayed, due to poor access to brush it. The access is also difficult for the dentist to do any drilling or restorations on a wisdom tooth, hence it is usually the treatment of choice to take it out.
Signs And Symptoms Of An Impacted Wisdom Tooth
The wisdom tooth being impacted in the jaw bone causes no pain as such, but what causes the pain is the associated issues that arise with the impacted tooth:
1- Pain in the molar region. this can be caused by pericoronitis (see above), or by causing damage to the molar tooth in front, where a wisdom tooth might dig a hole in it exposing the nerve.
2- Redness in the gums. The wisdom tooth might be just under the surface, this causes inflammation of the gums, and the become red.
3- Tenderness and bleeding. Just like any inflammation of the gums, the gums around the wisdom tooth gets tender and bleed easily.
4- Swelling in the jaw. An impacted tooth that develops a cyst or gets infected might express itself as a swelling in your jaw
5- Bad breath. The infection around the partially impacted wisdom tooth might not be severe enough to cause pain, but manifest as bad breath – a weird taste in your mouth
6- Headache. An impacted wisdom tooth might be pressing on your jaw and cases headaches.
How and Where To Take It Out:
Wisdom teeth removal is can be done at a dentist’s or oral surgeon’s office using just local anesthesia. A minor surgical procedure might be required at times to cut the gums around the tooth, and sometimes to cut some bone. Sectioning the tooth itself sometimes makes it easier to get it out.
This procedure can be done under local or general anesthesia.
Proper planning for the surgery is the basis for a more comfortable result. An x-ray, or even a CT-Scan is done to assess the condition and plan the procedure.
Challenges with the surgery:
just like any tooth extraction there is always the chance of excessive bleeding, tooth fracture, or breaking an adjacent tooth. However due to its position, the wisdom tooth has a higher risk for the following complications:
1- damaging the nerve that supplies the lip, this damage can be permanent, meaning you lose sensation in the lower lip forever.
2- damaging the nerve that supplies the tongue. This nerve s just under the gum on the inside to your wisdom tooth. During the procedure, it might get severed, meaning you lose sensation on that side of the tongue forever.
3- jaw bone breakage. Sometime the jaw bone is thin, and as we remove the wisdom tooth involving more bone trimming, this might leave the jaw bone thin and can break easily. Although not common, but can happen.
Wisdom tooth is a molar tooth, the procedure of taking it out varies from one person to another. Make sure to investigate your wisdom tooth with adequate examination and x-rays, and talk to us about taking it out. planning is the key.
Articles are written by Dr M Hajarat.