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 IMPACTED WISDOM TEETH

Wisdom teeth are also known as third molars. They are the third set of molars that usually develop at the age of 17 to 25 years. Teeth help in biting, chewing and grinding food. Different types of teeth include incisors (8), canines (4), premolars (8) and molars (8). Usually an adult has 32 permanent teeth. By the age of 13 years, 28 teeth are developed and remaining 4 wisdom teeth develop after 18 years of age. Wisdom teeth are located at the back of the mouth, two on top and the other two at the bottom. In some people, due to lack of space, the wisdom tooth may be embedded within the gum. This prevents the wisdom teeth from ejecting out, thus the person is said to have impacted wisdom teeth.

In some people, wisdom tooth may eject partially out of the gum or completely gets entrapped beneath the jawbone. Generally, the impacted wisdom teeth are associated with pain, swelling, tenderness and bleeding of gums. However, in some people the symptoms are absent. As impacted wisdom teeth are hard and difficult to clean, there are chances of tooth infection, decay and gum disease. Therefore, dentists may recommend a surgical removal of impacted wisdom teeth even when there are no symptoms.

SIGNS AND SYMPTOMS

The signs and symptoms are as follows:

  • Swollen gums
  • Tender gums
  • Painful jaw
  • Swelling around the jaw
  • Bad breath
  • Unpleasant taste

CAUSES

The causes of impacted wisdom teeth include lack of space for the newly emerging wisdom teeth and small jaw structure.

Newly emerging wisdom tooth in some cases finds its way up and lines up with other teeth. However, in some cases the wisdom tooth grows horizontally, completely stays entrapped in the jawbone. Wisdom tooth may grow at an angle towards back of the mouth and at a right angle to the other tooth. The impacted wisdom teeth exert pressure, which in turn pushes the adjacent tooth causing pain and disturbance while chewing.

RISK FACTORS

Risk factors for impacted wisdom teeth are as follows:

  • Age (17-25years)
  • Small jaw structure

COMPLICATIONS

The following are complications of impacted wisdom teeth

  • Chronic discomfort in mouth
  • Crowding of nearby teeth
  • Damage to other teeth
  • Difficulty flossing
  • Cysts
  • Gum disease
  • Infection
  • Cavities
  • Decay

The impacted wisdom teeth are difficult to clean. This may cause bacteria to develop, resulting in tooth decay and cavities.

DIAGNOSIS:

The dentist checks for any red, swollen, tender and bleeding gums. Complaints of other dental symptoms and its duration may be checked.

Dental X-rays: Dental X-rays are performed to check the presence of impacted wisdom teeth and the extent of bone damage.

 

TREATMENT:

Impacted wisdom teeth with or without complications (decay, cavities, gum disease, infection, and cysts) are surgically removed. Surgical tooth extraction is easily performed in younger people compared to older people as roots of the tooth are not completely formed. The surgery usually lasts for 30-60 minutes.

Anesthetic drugs may be given to numb the mouth. Impacted wisdom teeth excision involves the cutting of the gum followed by removal of small pieces of tooth. The surgical tooth extraction is simple if the impacted bone crosses the gum. It is quite difficult if the tooth is completely buried and impacted in the jawbone. After removal of the tooth, the wound is closed with stitches and socket is closed with gauze. Surgical removal of the impacted wisdom teeth may cause pain, swelling and bleeding at the surgical site.

RECOVERY

After the surgery, pain and swelling are managed by painkillers and ice packs respectively. Initially, the patient may be given liquid diet followed by a soft and regular diet. There will be difficulty opening the mouth for about a week and therefore it is advised to take soft foods that are easy to consume, such as ice-cream, yogurt, smoothies, oatmeal and mashed potatoes. Generally, in the case of elderly people, the healing process is slow. With proper wound care and management, recovery is fast.

In rare cases, after the surgery, there are chances of infection with entrapped food particles and bacteria destroying the nerve, jawbone, and tooth.

PREVENTION

Regular dental checkups (at least twice a year) help in early diagnosis and treatment of impacted wisdom teeth even before the symptoms occur. Thus, complications can be prevented.

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