Anytime you have a tooth that does not erupt (surface) correctly but rather stays submerged below the gum you have a problem. Sometimes this situation can cause significant pain, while other times it can be totally pain-free. When this occurs to a wisdom tooth (third molar), you have what is commonly referred to as an impacted wisdom tooth. This generally occurs when there is insufficient room in the mouth, and the wisdom tooth “impacts” or butts up against an adjacent tooth.

Third molars come in typically between the ages of 17 and 25, when a moderate amount of “wisdom” is supposedly achieved. Most people have four wisdom teeth; however, it is possible to have more or less. The key to not having issues generally depends upon one main factor: having adequate space for them to grow and erupt into proper position.

The most common consequence of having an impacted wisdom tooth is gum (periodontal) disease and damage to adjacent healthy teeth. This makes removing the impacted tooth so important. Another problem with impacted wisdom teeth is that they can affect other adjacent structures like gum, bone, nerves, blood vessels and sinuses. They can also become cystic, a condition in which the submerged tooth is surrounded by a closed sac or membrane that can cause possible infection and loss of bone.

We stress the importance of routine dental exams between the ages of 17 and 25 to catch problems with wisdom teeth before they start. The best time to remove a wisdom tooth is when it is not causing problems and the sooner and younger you are the better!

To learn more about the symptoms and treatment options of impacted wisdom teeth, continue reading the Dear Doctor magazine article “Wisdom Teeth.” Or, you can contact us today to schedule an appointment to discuss your questions.

The third molars, called “wisdom teeth” because they usually become visible when a person is 17 to 25 — supposedly the time we achieve wisdom, may have adverse effects on adjacent teeth. Most adults have four wisdom teeth, although some people have more; and some, none at all. The wisest thing to do about wisdom teeth may be to have them removed if they are poorly positioned.

What is an impacted wisdom tooth?

If a wisdom tooth is pushing against gums, other soft tissues, or adjacent teeth at an awkward angle, it is referred to as “impacted.” Usually this occurs when there is not have enough room in the jaws for these last molars to fit next to their adjacent teeth. They can disrupt the gum tissue attachment of their neighboring teeth and the surrounding bone leading to periodontal disease and, ultimately, their loss.

In many cases, impacted teeth are painless, and those who have them have no warning of the problem. Thus it is important to have routine dental exams during the time when the third molars are coming in.

When should wisdom teeth be removed?

It is better to remove wisdom teeth early rather than waiting until periodontal (gum) disease has set in. As individuals age, keeping their wisdom teeth may lead to more serious problems. Periodontal defects tend to get worse in the presence of retained third molars. Furthermore, there is a higher incidence of postoperative symptoms in people over 25.

What are the pros and cons?

Removing impacted third molars can have a negative influence on the periodontal tissues of adjacent second molars. A number of techniques, such as scaling, root planing, and bacterial plaque control, can be used to minimize periodontal problems and promote healthy healing.

Surgical removal of wisdom teeth will involve some mild to moderate post-operative discomfort. Use of aspirin or ibuprofen for a few days after surgery will provide pain relief and control most swelling and symptoms. Antibiotics may be prescribed to ensure infection-free healing. It is important to keep the socket area clean by washing and rinsing with saline or antibacterial rinses. Careful surgery will promote good healing with minimal periodontal consequences to adjacent second molar teeth.

To decide whether your wisdom teeth should be removed, you will need an evaluation to assess the clinical health of the wisdom teeth, the neighboring teeth, and other vital structures. X-ray and digital imaging techniques play an important role in determining the exact position of the wisdom teeth in the jaw. A full assessment and consultation will include all the risks, benefits, likely consequences, and alternative treatment options. This will provide you with the wisdom you need to determine what is best for your wisdom teeth.

To learn more about wisdom teeth, read “To Be or Not to Be: What are the consequences of an impacted wisdom tooth?” Or contact us today to discuss your questions or to schedule an appointment.