What Are Wisdom Tooth Impactions and Its Different Types
The third set of teeth that develop at the very back of the mouth are known as wisdom teeth, and they are usually the final teeth to form, usually at the age of 17-25. To most, these teeth do not present any serious issue. However, in a considerable percentage of the population, the wisdom teeth do not form out, but rather gets stuck, which according to the dentists, is known as impacted. Learning about wisdom tooth impactions, their nature, causes, and the need to do something about them may help you to maintain your oral health intact and prevent unwarranted suffering and complications.
Understanding Impacted Wisdom Tooth Extraction
A wisdom tooth that is affected is either one that lacks the space to develop fully or is formed at an unnatural angle. Being the final teeth to emerge, wisdom teeth often find themselves with a dental arch that is already congested, and does not provide much to no allowances that a normal eruption pathway can follow.
Impaction in dentistry means any tooth which is obstructed in being cut through the gum line. The adjacent teeth, dense bone, and even the angle in which the tooth is developing can be the cause of this blockage. The outcome is an incomplete or complete retained tooth under the gum, which forms an ideal condition to become infected, painful and cause structural damage of the adjacent teeth.
The wisdom teeth tend to be the worst of all since they all tend to emerge late in life. The development of the jaw is usually finished at the end of the teens, so there is hardly ever enough space to accommodate these newborns. That is exactly why dentists suggest that it is better to examine such cases as early as possible – preferably in the middle to late teenage period – in order to detect any possible impaction and prevent any complications.
Common Impacted Wisdom Teeth Symptoms
Not all affected wisdom teeth have dramatic symptoms – some of them are silent and may take years to manifest. Nonetheless, when they manifest themselves, they may be mildly uncomfortable to extremely disruptive. The commonest symptoms that are reported are:
Some of the first indicators are pain or pressure around the jaw. This pain is normally experienced at the very back of the mouth and may extend to the jaw, neck or even the temples. It is reported by most patients as dull and persistent, and aggravated by biting.
The other hall mark symptom is difficulty chewing, or opening your mouth. Even basic activities such as eating or yawning can be painful as the affected tooth rubs against the other tissues and other molars.
Molar back swelling would be typical as well. The gum tissue that is around partly erupted wisdom tooth is usually inflamed and tender to touch. In others, there may be swelling all the way to cheek or jaw that is visible.
There may also be headaches or earaches. The referred pain caused by an affected wisdom tooth may run up the trigeminal nerve, and may result in headaches, earaches or even stiffness in the neck and this can be confused with other symptoms that are not related to the affected tooth.
Swollen Gums and Risk of Infection
Among the consequences of wisdom tooth impaction, there is a high risk of infection one of the most serious. An eruption of a wisdom tooth through a gum line, though the tooth has not erupted fully, leaves an opening that accumulates bacteria readily. The crevice of gum tissue the operculum serves as a trap to any food debris as well as harmful microorganisms.
It is a gum tissue inflammation around a partially erupted tooth and is known as pericoronitis condition. Wisdom teeth pericoronitis is associated with swelling of the gums surrounding the wisdom tooth, foul breath or unpleasant mouth taste, pains that can later extend to the ear or throat, and difficulty when swallowing or completely opening the mouth.
In more complicated cases, the infection may lead to pus discharge and fever. Otherwise, pericoronitis may extend to the mouth, throat, and neck, which is a potentially fatal complication. Repeated incidences of pericoronitis is an excellent indication that growth of the wisdom teeth needs to be extracted.
Bad breath and infection of the wisdom teeth are not simple inconveniencing factors. Continued bacterial action in a wisdom tooth pocket may endanger the wellbeing of the nearby teeth, bone loss and even lead to other systemic health problems in case bacteria penetrate the blood.
How Impacted Wisdom Teeth Affect Your Mouth
The effects of the impaction of a wisdom tooth go far beyond the location of impaction. In the long run, these teeth may lead to a series of structural and functional issues of the entire mouth.
Wisdom teeth pressure on molars is a widespread issue. When a tooth affected goes and collides with the second molar, it may cause pain and cause damage and may make the neighboring tooth loose. Severe cases may cause the root of the second molar to start resorbing, that is, the root slowly dissolving as a result of physical pressure of the affected tooth.
Misalignment and crowding of wisdom teeth is also a commonly seen outcome. Although a wisdom tooth may not bulge outward, the strain it puts on the other teeth may cause them to have their placement altered overtime and, therefore, new devices of straightening those teeth used over years of orthodontic therapy can be reversed. This is the reason why the orthodontists usually suggest that the wisdom teeth should be checked before, during or after braces.
Moreover, the affected wisdom teeth may lead to deep gum pockets between the wisdom tooth and the second molar -pockets that are extremely hard to clean and very prone to decay and periodontal disease.
Types of Wisdom Tooth Impaction
Impactions are not all alike. Dentists categorize the impaction of wisdom tooth according to the location and the inclination of the tooth and this directly determines how complex the extraction will be.
- Vertical impaction is caused when the tooth is laid straight when it cannot break through the gum completely. These are the least complex ones that can be treated surgically.
- The most frequent is mesial (or angular) impaction. The molar is tilted exclusively in front of the mouth that presses squarely against the other second molar. This angle can be seen to complicate extraction compared to a vertical impaction.
- One of the more complicated wisdom tooth impaction types is the horizontal impaction. The tooth is on its side and under the gum and is basically at right angles of the other teeth. Horizontal teeth nearly always need to be extracted surgically and have greater risks of being vulnerable to nerves.
- In distal impaction, the tooth is tilted backwards, towards the back of the jaw. This is the rarest form but may also lead to major problems and usually has to be surgically removed.
When Extraction Is Recommended
Wisdom teeth extraction recommendation depends on a combination of clinical symptoms, radiographic findings and the general health of the teeth in the patient. It is usually recommended to extract when:
There is recurrent swelling or pain. When you are having recurrent counts of pains, swelling, or discomfort in the area of your wisdom teeth, it is a definite indication that the tooth will not heal itself, and thus it needs to be extracted.
There are recurrent infections or pericoronitis. Over one episode of pericoronitis is a strong indication that the wisdom tooth is a chronically troublesome area and it is under risk of infection.
Local teeth or jaw bone is damaged. The loss of the bones in the area of the wisdom tooth, or the loss of adjacent molars, or radiographic evidence of root resorption is all strong arguments in favour of the wisdom teeth extraction.
This influences orthodontic treatment. Should the affected wisdom teeth be a cause of crowding, shifting, misalignment, the removal of wisdom teeth may be advised to maintain the outcome of orthodontic treatment or enable the ongoing treatment to be successful.
Radiation Technology X-Rays, 3D.
Safe and effective wisdom tooth management is based on accurate diagnosis. Dental imaging is important in determining the position, angulation, and root formation of affected wisdom teeth, and their distance with the important anatomical structures.
Normal dental X-rays, especially panoramic X-rays would give a general picture of the whole mouth where the dentist can determine the angles of impaction, the length and curvature of the roots, and the extent of bone coverages.
In a more complicated situation, CBCT (Cone Beam Computed Tomography) or 3D scan might be necessary. This new technology of imaging displays a 3D picture of the jaw allowing the accurate localization of the inferior alveolar nerve, the bone density, and exact localization of the spatial relationship between the affected tooth and the rest of the structure. The information is priceless in surgical planning and reducing the risks of nerve damage during extraction.
Preparing for Impacted Wisdom Tooth Surgery
The most important part of a successful operation and a shorter recovery is the preparation. A specific pre-operative plan will be given to you by your dental team, though several standard procedures are involved.
The pain management and anti-inflammatory drugs can be prescribed or advised in the days before the surgery to minimize the inflammatory background and make the procedure easier. In the situation of an active infection during the time of assessment, there will likely be an antibiotic prescription that will delay the extraction until the infection has healed, in case the infection is spread during operations.
Chlorhexidine or saline solution rinses given as oral suspension can be suggested to minimize the number of bacteria in the mouth and set the surgical site ready. Also in lifestyle changes can be important – you must not smoke at least 48 hours prior to surgery, must be well hydrated and can be subject to any dietary restrictions given to you by your oral health providers. Post-operative complications such as dry socket are very likely to occur in smoking.
Post Extraction Care and Surgery
The wisdom tooth surgery recovery takes time depending on the complexity of the extraction procedure and to the largest part most patients have the majority of the swelling and pain during the first 48-72 hours. Swelling may also be treated with the application of ice pack to the jaw outer part in the first 24 hours.
It is important to maintain surgical site cleanliness. Although safe cleaning methods are suggested by your dentist or oral surgeon, usually, it is to rinse gently with warm salt water after eating, starting 24 hours after surgery. The first practice to avoid during the immediate after-operative period is vigorous rinsing, spitting or using straws because this may cause the blood clot, which is covering the healing socket, to be dislodged.
Dry socket is the most frequent complication during the post-operative phase; this is a painful condition in which the protective clot is lost too soon and which exposes the underlying bone. The symptoms of dry socket are an acute exacerbation of pain that occurs by day three to five after surgery and the conspicuous sight of an empty socket. In case you are suspecting dry socket, call your dental provider immediately.
Follow-up appointment will be done by your dental team to check on healing process and in case sutures were provided, they will be removed. In case of growing pain, fever, constant swellings, and any indications of post-operative infection, you should not wait till your appointment time but seek medical attention.
Bottom Line
In case you are having signs of a wisdom tooth impaction or just want a qualified dental practitioner to examine your wisdom teeth, there are specialist practices located in Melbourne with a lot of experience as far as impacted wisdom tooth extraction is concerned.
Our dentist in Melbourne specialises in the assessment of all forms of wisdom tooth impactions and surgical removal of the same. Our staff employ advanced imaging techniques, such as 3D CBCT scan, in order to plan each procedure with accuracy and consideration. Our dentist is well trained to handle your simple or complex case, extract safely with minimal inconvenience to your daily life.
Waiting until the pain is unmanageable is not the solution. The best method of averting the long-term complications of wisdom tooth impaction is an early-evaluation. Schedule an appointment now and start making healthy oral health a long-lasting one.