Impacted Wisdom Teeth Extraction: Symptom, Treatment & Recovery
Wisdom teeth, also known as the third molars are the chewing teeth found furthest at the back of the mouth. These teeth, unlike other teeth, come in during a person’s late teens and early twenties. In most cultures around the globe, this age is considered the age of maturity hence the term ‘wisdom.’ The only problem with these teeth is that they can grow sideways or be impacted. By definition, an impacted wisdom tooth refers to a tooth which has failed to erupt into the expected position completely. Tooth impaction may occur because there is not enough space in the jaw to allow them to emerge completely. It may also occur because the tooth’s angulation is improper.
Wisdom teeth impaction can be very painful and can also cause other serious dental complications if not taken care of. It is crucial that you visit your dentist as soon as you start developing wisdom teeth. It is vital to have wisdom teeth extracted early enough since the longer it takes for them to be extracted the harder it becomes.
This article is going to discuss more impacted wisdom teeth: Symptoms, treatment, and recovery.
Contents
What are Impacted Wisdom Teeth?
Impacted wisdom teeth are a common condition among a majority of people around the globe. It’s a condition where an individual’s wisdom teeth will begin to erupt, but not have enough room in the jaw to come in fully. As a result, this will cause the wisdom teeth to push against other teeth as they try to erupt fully. They can also become stuck between the gums and the bone. In the event of a partial eruption, bacteria can grow and lead to an infection. Sometimes it is not necessary to remove impacted wisdom teeth if they have enough space in the mouth to grow without any complications. However, this is not always the case. When they fail to grow as they should, it is paramount to remove them since they can result in problems in the future.
Impacted wisdom teeth can also be caused by genetics, which plays an integral role in determining the size of the tooth and the jaw size. Impacted wisdom teeth can lead to damage or inflammation of the adjacent teeth. These teeth are classified on the basis of depth and direction of impaction. They can also be classified on the amount of soft tissue on the jaw bone that covers them as well as the amount of space available for them to erupt.
Here are some of the common terms you might hear your dentist use while describing impacted wisdom teeth:
- Vertical Impaction- These types of impacted wisdom teeth grow fairly straight, but they lack enough room on the jaw bone to emerge as they should.
- Soft Tissue Impaction- In this situation, the wisdom teeth get stuck into the gum tissue as it tries to grow and erupt on the surface. This kind of impaction is normally associated with pain and disruption of dental alignment.
- Mistal/Mesial Impaction- This is the most common type of impaction. The tooth angles forward towards the mouth as it tries to erupt. In most cases, this ends up pushing the other teeth in the mouth forward.
- Partial Impaction- This is a condition where the wisdom tooth fails to emerge fully due to disruption by the neighbouring tooth. When you are suffering from this type of impaction, food debris and bacteria can get stuck underneath the tissue opening. This can cause infection leading to pain or other oral health complications.
- Bony Impaction- This type of impaction deals particularly with the wisdom teeth that fail to emerge through the gums but instead remain trapped in the jaw bone. Bony impaction wisdom teeth are covered by a layer of bone.
- Horizontal Impaction- This type of impacted wisdom tooth lies on its side with the jaw bone and directly towards the existing neighbouring tooth instead of growing vertically towards the gum line.
Signs and Symptoms of Impacted wisdom teeth
When your wisdom teeth grow in, they usually come in with some discomfort. There are several signs and symptoms that would make it necessary for you to have your wisdom teeth extracted. Here are some of the side effects that you may experience until you have your wisdom tooth removed.
– Persistent Pain
Mouth pain is one of the signs and symptoms that indicate your mouth has a problem. It is the first thing to note when your wisdom teeth have become impacted, and they are interfering with the nerves that run through your jaw. However, these symptoms may also be caused by inflammation, gum disease or an infection of the tissues around an affected tooth. These symptoms which are the most common for all oral complications, do not always essentially mean that you have impacted wisdom teeth. But, it is always important to visit your dentist so that he/she may give you the most accurate evaluation of your mouth.
– Swollen, Tender and Bleeding Gums
Impacted wisdom teeth can result in severe gum problems such as swollen and tender to touch gums. Your gums may even start to bleed when you exert too much pressure while brushing or even flossing. This makes it difficult for you to undertake your daily oral care routine. It is good to note that impacted wisdom teeth can lead to such symptoms but it can also be other forms of gum disease. Therefore, to be sure, it is best advised to visit your dentist for a consultation.
– Difficulty opening your Jaw
Not only do impact wisdom teeth cause your gums to swell but also your jaws. When your jaws get swollen, they can make it difficult and painful for you to open and close your mouth. This jaw pain is not always painful at first, however, as time goes by it will possibly become more intense. The pain may also be coming and going in phases, and this may leave you feeling uncomfortable only to have this pain disappear after a few days. Unluckily, this pain will most likely return. Therefore, do not ignore this pain, even if it disappears for some time.
– Swollen Glands in the Shoulder and Neck
It is common to have the glands in your shoulder and neck swollen when you have impacted teeth. When this symptom is combined with swollen gums, it is a definite sign that you may be experiencing impacted wisdom teeth, and you should seek medical attention immediately.
– Sinus Issues
You can tell that your wisdom teeth are coming in if you experience sinus pain, pressure, and congestion, mainly in your upper jaw region. The growth of the wisdom teeth and development of its roots can exert pressure on the sinuses found above and behind your jaws. Due to this pressure on the sinuses, you may experience persistent headaches and sinus pain.
– Unpleasant Taste in the mouth
It can be quite difficult to clean through your gums and teeth when you have impacted wisdom teeth. Therefore, this makes an impacted wisdom tooth a breeding spot for bacteria thereby resulting in infections and tooth decay. When infections and decay develop, it may cause your mouth to have a bad taste and breath.
Oral Complications of Impacted Wisdom Teeth
Impacted wisdom teeth can lead to more complications in severe cases. As much as impacted wisdom teeth themselves can result in severe pain, the real issue comes in from the complications that may arise as a result.
– Development of Cysts
Wisdom teeth grow inside a sac within the jaw bone. This sac can become filled with fluids forming a cyst which can cause damage to the teeth, jaw bone and nerves. In other rare cases, a tumour which is usually noncancerous can develop. Your dentist will need to remove some tissues and bone to treat this complication.
– Damage to the Adjacent Teeth
In case a wisdom tooth grows in pushing against the second molar, it may cause damage to the second molar or increase the risks of infection around that region. The pressure exerted on the second molar may also lead to issues with the overcrowding of the other teeth which will require an orthodontist to straighten the teeth.
– Tooth Decay
Wisdom teeth that are partially developed are at a higher risk of developing tooth decay than fully grown teeth. Usually, this happens because impacted wisdom teeth are hard to reach and thus do not get properly cleaned. Therefore, food remains and bacteria get trapped between teeth and gums resulting in tooth decay.
Diagnosis of Impacted Wisdom Teeth
Before you can undergo any form of impacted wisdom teeth removal, you will first meet your oral surgeon for a consultation. During the visit, you will be required to provide your dental and medical history to your surgeon. This is to make sure that you do not have any prior problems that may interfere with the recommended treatment. Your dentist will then conduct a thorough examination of the state of your mouth, jaw, and teeth. He/she will also take x-rays of your wisdom teeth as well as the neighbouring teeth before any treatment can commence.
If the surgeon recommends that the surgical method is the best treatment for your condition, he/she will explain the entire procedure to you. He will explain the risk and benefits involved and will also answer all your question concerning the procedure. You will also be provided with some specific guidelines on what to do and what not to do before the surgery.
Treatment of Impacted Wisdom Teeth
You do not need to undergo any treatment if your wisdom teeth have emerged in the right way and they are not causing any problems. You can take some over-the-counter medications to alleviate any discomfort that may be caused by the condition. However, you still need to be sure that you are able to brush, floss and clean your wisdom teeth thoroughly without any difficulties. Also, ensure that you visit your dentist regularly to examine the condition of your wisdom teeth. The condition of wisdom teeth changes a lot, especially between the age of 16 and 23. If your dentist has suggested that your wisdom teeth are problematic, here are some of the treatments you can undergo:
1. Coronectomy
Coronectomy is a surgical procedure used by an oral surgeon when impacted wisdom teeth extraction has a high risk of alveolar nerve injury. In such a case, the wisdom teeth in the lower jaw often press on a wrap around the nerve that supplies feeling to the tongue, lips, and chin. Research shows that such a procedure has the risk of damaging the inferior alveolar nerve or the lingual nerve. This can leave you with a temporary or permanent loss of feeling.
During this procedure, your dental surgeon will remove the crown of the tooth leaving the nerves untouched. This form of treatment is preferred when the roots are within the immediate vicinity since it prevents neurological damage. Damage caused to these nerves may interfere with many aspects of life including eating and speaking. Here are some of the situations that may make your surgeon recommend Coronectomy:
- If you have an infected tooth or root
- If there is any root mobility discovered by your surgeon during the surgery
- If the roots of your tooth are too close together
- If the tooth is impacted horizontally along the inferior alveolar nerve
2. Local Treatments
You can also treat your wisdom teeth through local treatment. In situations where there is inflammation of the soft tissues in the area surrounding the impacted tooth, you can clean the place and use some antiseptic rinse. You can also use antibiotics for severe cases.
3. Impacted Wisdom Teeth Removal
– Before the Surgery
When a wisdom tooth is impacted, the chances are high that your dentist will recommend extraction as the ideal solution. If ignored, it is almost certain that it will cause some complications especially if it is located on the lower jaw. For proper wisdom teeth removal, the dentist needs to carry out a proper diagnosis. During the diagnosis, the dentist will assess any signs of infections that include swollen or red gums. He/she will also take an x-ray to determine the position of the impacted wisdom tooth and the extent of damage caused by the tooth. Once all that is done, your dental surgeon will then proceed to a wisdom tooth removal procedure.
– During the Surgery
The dentist will administer either local or general anaesthesia depending on your level of anxiousness to numb your mouth. Anaesthesia will also help in suppressing your consciousness during the procedure. Here is the different type of anaesthesia your dentist can use on you depending on the level of your anxiety and how the procedure is being carried out.
- Local Anaesthesia- This type of anaesthesia is administered through an injection into the area surrounding the impacted wisdom teeth. The anaesthesia will prevent you from feeling any pain during the procedure.
- Local Anaesthesia and Intravenous Sedation- This type of anaesthesia will make you feel relaxed during the procedure, and you will also be less aware of what is going on.
- General Anaesthesia- This type of anaesthesia will make you sleep and will thus prevent you from feeling any pain. General anaesthesia is mostly used when the dentist is removing all four teeth at once.
After administering the anaesthesia, your oral surgeon will then make an incision on the gum covering the tooth to expose it. He/she will then open up and separate the tissue connecting the tooth and the jaw bone. This will enable the dentist to remove the tooth with much ease. Sometimes the dentist may be forced to cut the tooth into smaller pieces for easy extraction. The dentist will finally suture the opening in the gum line and allow the area to heal.
– After the Surgery
After the surgery, the dentist will send you home with clear instructions on what to do to speed up your healing processes and avoid any post-surgery complications. Here are some guidelines you should follow:
Postoperative Pain
Just like any other surgery, extracting wisdom teeth can lead to some discomfort within the first few days after the procedure. This pain is expected, and it can be reduced with some simple painkillers. Your dentist will prescribe you the correct medication and dosage depending on how your procedure went. These prescribed pain medications should not be long-term, and you will gradually start to wean them off as the pain reduces. Also, depending on the infection status of your tooth, the surgery, and your general body health, you may be prescribed some antibiotics. If you get prescribed antibiotics, make sure that you complete the whole course. Do not stop even if the symptoms are gone.
– Swelling
Swelling around your eyes, cheeks, sides of the face and mouth is usually expected. The amount of swelling is dependent on the proportionality of the surgery involved. Swelling is your body’s normal reaction to the procedure and repair of the tissues. The swelling may not be obvious on the first day of the surgery, but it will become more visible the day following the surgery. It will reach its maximum 3-4 days after surgery. To reduce the swelling, apply ice packs to the sides of your face where the surgery was performed.
– Bleeding
The amount of bleeding you experience will depend on the number of wisdom teeth you have extracted. Your dentist will place a gauze pad where the tooth has been extracted. It is recommended that you keep the gauze pad in place for at least 30 minutes to help stop the bleeding and assist with clotting.
– Use a Mouthwash or a Salt Water Rinse After 24 Hours
Gently rinse out your mouth with some salt water or an antiseptic mouthwash 24 hours after the surgery. Avoid rinsing your mouth vigorously since this can loosen up the blood clots developing in the empty socket. Mix a teaspoon of salt with 250 ml of water and rinse your mouth with this solution a few times throughout the day. A salt water rinse will help to reduce pain and swelling.
– Have Soft Foods
For the first 24 hours after surgery stick to only soft foods such as applesauce and yogurt. You can gradually add on semisoft foods when you start to heal properly. Keep off chewy, hard, spicy or hot foods that may stick in your empty socket or cause irritation to the wound.
Possible Complications of Impacted Wisdom Teeth Removal
Having your wisdom teeth extracted is a rather minor and straightforward procedure. However, it is always essential to note that it is a surgery and all surgeries carry some element of risk. Provided you have this procedure with a well-qualified and experienced dentist the chances of these complications are minimal.
– Dry Socket
A dry socket is formed when blood does not clot in the socket within the first three to five days after the procedure, and this can cause a lot of pain. It has been found that between 5%-30% of people who have had their wisdom tooth extracted have experienced severe pain and inflammation of this aftereffect. To prevent this from occurring, refrain from exercising, smoking, sneezing or drinking carbonated beverages.
– Nerve Injuries
There is a nerve found near your wisdom tooth that transmits signals from your lower lip, lower teeth, and chin to your brain. In most people, there is a gap that exists between the wisdom teeth and the nerve. However, in other people, this gap does not exist. If the gap does not exist, then the nerve can easily get irritated by the procedure leading to the lower half of your jaw and lips being numb. The numbing effect can take a few days or even a week after the surgery. In other extreme cases, this effect can become permanent.
– Restricted Mouth opening
A restricted mouth opening may occur as a result of swelling, but it always heals when the swelling decreases. People suffering from this condition, whereby their mouth opening is restricted need to modify their diet and eat soft foods or liquids. Also, despite the restricted mouth opening it is important to maintain proper oral hygiene to avoid infections that could complicate the swelling.
– Sinus Perforation
Wisdom teeth grow in close proximity to the sinus cavities. You may notice this in a dental x-ray since it looks as if the roots of the wisdom teeth are practically in the sinus. Usually, this does not happen since there is a thin bone that separates the roots of the teeth from the sinus. However, in some rare cases during wisdom teeth removal the thin piece of the bone comes along with the sinus. Mostly this occurs when the roots of the tooth are close to the bone due to an infection. In such instances sinuses may be perforated.
Bottom Line
If there is ever an oral complication you would want to avoid, it is impacted wisdom teeth. If not properly taken care of, it can lead to severe oral complications. Unfortunately, you can never dictate how your wisdom teeth will grow and the size of your mouth. Fortunately, there are some treatment options to consider. Just visit your dentist regularly to track the progress of your wisdom teeth. In the event that extraction is the only remedy, don’t shy away from the procedure. If done right by a professional, the entire process will be painless and attract less discomfort. Moreover, with proper aftercare, it will only take you around two weeks to recover fully.
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