Impacted Wisdom Tooth

Symptoms Of Impacted Wisdom Tooth

The most common signs and symptoms of impacted wisdom teeth include:

• Pain or discomfort 

• Swelling

• Red or bleeding Gums

• Jaw stiffness

• Bad breath

• Difficulty opening mouth

• Headache

• Ear pain

• Unpleasant taste or dour in the mouth

• Swollen lymph nodes

Impacted teeth can create hard-to-reach areas in the mouth, increasing the risk of plaque buildup, cavities, and gum infections. Proper oral hygiene is essential to prevent complications and keep the mouth healthy.

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Types Of Impacted Wisdom Tooth

Impacted wisdom teeth are classified based on their growth angle and position relative to adjacent teeth and the jawbone. Common types include:

1. Mesioangular Impaction: The wisdom tooth is angled toward the front of the mouth, pressing against the second molar.

2. Vertical Impaction: The tooth is upright but fails to fully emerge through the gum line.

3. Horizontal Impaction: The tooth lies horizontally in the jaw, pressing against adjacent teeth.

4. Distoangular Impaction: The tooth is angled toward the back of the mouth, away from the second molar.

5. Transverse Impaction: The tooth is positioned sideways, at a 90-degree angle to its normal alignment.

6. Inverted Impaction: The tooth is upside down within the jaw, often requiring complex removal.

Note: Apart from these a soft tissue impaction occurs when a wisdom tooth partially erupts. In contrast, a bony impaction involves the tooth being fully trapped in the jawbone.

Causes Of Impacted Wisdom Tooth

• The primary cause of impacted wisdom teeth is evolutionary changes in the human jaw structure. 

• Over time, as our diets have evolved and dental hygiene practices have improved, the size of the human jaw has become smaller. 

• This reduction in jaw size often leads to insufficient space for the third molars, or wisdom teeth, to emerge properly. 

• As a result, the wisdom teeth can become impacted. Here are some specific factors and causes:

  • Angulation of the tooth

  • Late eruption

  • Crowded teeth

  • Soft tissue obstruction

Risk Factors of Impacted Wisdom Tooth

The causes and risk factors for impacted wisdom teeth are related but not identical. Common risk factors include:

1. Jaw Size

Individuals with smaller jaw sizes may have less space for the wisdom teeth to properly emerge, increasing the risk of impaction. Factors that affect the jaw size include:

• Feeding habits in infancy

• Childhood habits like thumb sucking

• Cross-breeding

• High sugar consumption

2. Age

Wisdom teeth typically begin to emerge in the late teens or early twenties. The age at which the teeth start to come in can influence the likelihood of impaction.

3. Poor Dental Hygiene

Inadequate oral hygiene can lead to gum disease and infections, which may affect the proper eruption of wisdom teeth.

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4. Previous Extractions

If you have had other teeth extracted, it might alter the alignment of the remaining teeth, impacting the eruption of wisdom teeth.

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5. Genetics

Having a family history of impacted teeth can increase your chances of getting impacted wisdom teeth.

Diagnosis Of Impacted Wisdom Tooth

Diagnosis of an impacted wisdom tooth typically involves the following:

1. Clinical Examination

• A dentist or oral surgeon will begin by conducting a thorough clinical examination of the mouth, teeth, and surrounding tissues. 

• They will assess for signs and symptoms associated with impacted wisdom teeth, such as pain, swelling, redness, difficulty opening the mouth, and evidence of infection.

2. Imaging Tests

• X-rays: Dental X-rays, like TMJ X-rays or periapical X-rays, help assess wisdom teeth's position, angulation, and proximity to other teeth, and detect issues like cysts or abscesses.

• CBCT Scan: A cone-beam computed tomography (CBCT) scan may be recommended for detailed 3D imaging of an impacted tooth and surrounding structures, aiding in precise treatment planning for complex cases.

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Prevention Of Impacted Wisdom Tooth

• The impaction of wisdom teeth cannot always be prevented, as it often depends on factors like genetics, jaw size, and tooth alignment. 

• However, maintaining good oral hygiene and regular dental check-ups can help monitor wisdom tooth development and address potential issues early. 

• Early removal of wisdom teeth showing signs of misalignment or lack of space in the jaw may prevent complications associated with impaction.

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Specialist To Visit

Experts who can help you diagnose and treat impacted wisdom teeth are: 

• General dentist

• Oral & maxillofacial surgeon

A general dentist can evaluate your overall oral health, identify any issues with your wisdom teeth, and provide initial recommendations.

An oral and maxillofacial surgeon can expertly assess, extract, and manage complications of impacted wisdom teeth for safe and effective treatment.

When to see a doctor?

Consult a dentist immediately if you have:

• Persistent pain or swelling around the wisdom tooth.

• Difficulty in opening your mouth or chewing.

• Signs of infection like redness, pus, or bad breath.

• Jaw stiffness or swelling spreading to the face.

• Repeated episodes of discomfort or inflammation near the tooth.

• Adjacent teeth damage.

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Treatment Of Impacted Wisdom Tooth

The treatment of an impacted wisdom tooth depends on various factors, including the severity of impaction, symptoms, and the individual's overall oral health. Here are common treatment options:

1. Observation

• In cases where the impacted wisdom tooth is not causing any symptoms,the dentist may recommend a wait-and-see approach. 

• Regular monitoring through dental check-ups and X-rays can help track any changes in the condition of the impacted tooth.

2. Extraction 

• The most common treatment for an impacted wisdom tooth is surgical extraction. 

• This involves removing the impacted tooth surgically under local anesthesia or sedation.

•  Depending on the position and complexity of the impaction, the dentist or oral surgeon may need to perform a simple extraction or a more complex surgical extraction.

3. Preventive Extraction

• Some dentists may recommend preventive extraction of impacted wisdom teeth, even if they are not currently causing symptoms. 

• This proactive approach helps prevent potential future problems such as infection, damage to neighboring teeth, gum disease, and cyst formation.

4. Medications

• Antibiotics: If an impacted wisdom tooth shows signs of infection or inflammation, antibiotics may be prescribed to manage symptoms temporarily. Commonly used ones are:

  •  Amoxycillin

  • Clindamycin

  • Metronidazole

• Analgesics (Pain relief): Over-the-counter pain medications may be recommended to manage pain and discomfort associated with an impacted wisdom tooth. Common ones include:

  • Ibuprofen 

  • Paracetamol 

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4. Other Procedures

• Operculectomy: If a wisdom tooth is partially erupted but blocked by thick gum tissue, this procedure removes the tissue to help the tooth erupt. If the tooth still doesn't emerge fully, removal might be needed.

• Autogenous Transplantation: Third molars can be moved to another site, like a missing first molar's spot. However, this is rarely done due to a low success rate, except in special cases.

• Orthodontically Guided Eruption: This technique uses braces to help impacted teeth, like canines or premolars, move into the correct position in the dental arch.

• Eruption-Activating Procedures: These methods are applied to developing teeth to encourage their eruption into the correct position.

Home- Care For Impacted Wisdom Tooth

Home remedies can help alleviate discomfort associated with impacted wisdom teeth temporarily, but it is important to consult a dentist and get the right treatment. Here are some home remedies that may provide relief:

1. Saltwater rinse: Gargling with warm saltwater can help reduce inflammation and alleviate pain associated with an impacted wisdom tooth. 

How To Do It?

Mix half a teaspoon of salt in a glass of warm water and rinse your mouth thoroughly several times a day.

2. Cold compress: Applying a cold compress or ice pack to the outside of the cheek near the affected area can help reduce swelling and numb the pain. 

How To Do It?

Wrap an ice pack in a cloth and apply it to the affected cheek for 15-20 minutes, repeating every few hours to reduce pain and swelling.

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3. Soft Diet: Stick to a soft diet consisting of foods that are easy to chew and swallow to avoid putting pressure on the impacted tooth. Some examples include soups, yogurt, smoothies, fresh fruit juices, etc.

4. Clove (Laung) Oil: Clove oil contains eugenol, a natural anesthetic that can help numb the area and reduce pain. 

How To Use It?

Apply a small amount of clove oil to a cotton swab and dab it onto the gums near the impacted tooth.

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5. Peppermint: Peppermint has natural anti-inflammatory properties that can help that has been used to treat gum inflammation. 

How To Use It?

Brew a cup of peppermint tea or use peppermint oil as mouthwash and gargle your mouth with it.

Complications Of Impacted Wisdom Tooth

Impacted wisdom teeth can lead to various complications, and if left untreated, these issues can become more severe. Common complications of impacted wisdom teeth include:

1. Pericoronitis: It is an inflammation of the soft tissues surrounding a partially erupted or impacted tooth, commonly a wisdom tooth. It occurs when food debris, plaque, or bacteria get trapped under the gum flap, leading to infection.
   
   

2. Gum disease (Periodontitis): Impacted wisdom teeth can create pockets where bacteria can accumulate and lead to inflammation of the gums.
   
   

3. Cysts and tumors: Impacted wisdom teeth can sometimes lead to the formation of cysts (fluid filled cavities) or tumors around the impacted tooth. These abnormalities can damage surrounding bone and tissues.
   
   

4. Damage to adjacent teeth: Wisdom teeth may push against adjacent teeth as they try to emerge, causing misalignment or damage to nearby teeth.
   
   

5. Abscess formation: Untreated infections around impacted teeth can lead to the formation of abscesses, which are pockets of pus. 
   
   

6. Sinus issues: Impacted upper wisdom teeth can sometimes affect the sinus cavity, leading to sinus pain, pressure, or sinus infections.
   
   

7. Difficulty in cleaning: Proper oral hygiene around impacted wisdom teeth can be challenging, increasing the risk of decay and infection.
   
   

8. Speech and chewing problems: Impacted wisdom teeth can cause discomfort and difficulty in speaking or chewing.

Note: If you are experiencing any of these issues it is better to get the impacted wisdom tooth removed.

Living With Impacted wisdom tooth

• Living with impacted wisdom teeth can be challenging due to the potential for discomfort, pain, and the risk of complications. 

• You can try the home remedies mentioned in the above section to get some relief.

• However here are a few tips that you will need to follow once you get the impacted wisdom tooth removed.

Post-Surgical Tips 

• Reduce swelling with cold compresses for the first 24 hours.

• Avoid strenuous activities for a couple of days.

• Stick to soft foods like yogurt, soups, or mashed foods.

• Prevent dry socket (painful condition where the blood clot at a tooth extraction site dislodges or dissolves, exposing the underlying bone and nerves) by avoiding drinking from straw

• Refrain from smoking as it can hamper healing

• Gently rinse with warm salt water but avoid brushing near the site initially.

• Take prescribed pain relievers and antibiotics as directed.