The third molars, or the wisdom teeth, are usually the last teeth to develop in the mouth. Their full root development is usually completed in the late teens to the early twenties, depending on each person’s genetics.
While wisdom teeth do not cause problems for everyone, the majority of the population these days do not have sufficient space in their mouths for a third set of molars. This is due to the fact that most people are keeping their front teeth, or are so focused on straightening the front teeth, that they leave less room in the back for the third molars causing their impaction.
What are Impacted Wisdom Teeth?
When inadequate space prevents the wisdom teeth from fully erupting into the mouth, they become impacted and infected. Even if the impacted wisdom teeth sit below the gums, they can still become infected and cause complications by putting pressure on the adjacent teeth and surrounding soft tissue. The assumption that a lack of symptoms is a sign of no problem has been proven wrong time and time again in multiple scientific papers. AAOMS white paper: “The absence of symptoms does not indicate absence of disease or pathology.”
If impacted wisdom teeth cannot be cleansed and are not in function, they should be removed before they become symptomatic and cause pain. Impacted third molars can lead to serious life-threatening infections that spread into the head and neck region causing difficulty in breathing and even death.
Symptoms of Impacted Wisdom Teeth
Look for the signs of impacted wisdom teeth, including:
- Swelling and/or redness of the gums behind the second molars in the back of the mouth
- Difficulty opening the jaw (Trismus)
- Pain while chewing or biting down
- Bad breath (Halitosis)
- Bad, salty taste in the mouth
Types of Impactions
If you believe you may have symptomatic impacted wisdom teeth and have not yet seen a dentist for a while, please give us a call today. Dr. Massoomi will take a Panorex X-ray and fully examine your wisdom teeth and determine if they need to be removed. As for asymptomatic impacted wisdom teeth, we recommend that your see your dentist first to have a comprehensive dental examination to determine if there is any other dental issues that need attention first, i.e. cavities. After they have fully examined and treated the rest of your dentition, they may recommend preventative removal of your third molars if they are impacted. Remember: “The absence of symptoms does not indicate absence of disease or pathology.”
The four types of wisdom teeth impaction include:
Soft tissue impaction | In a soft tissue impaction, the tooth may emerge through the jaw bone, but there is still some gum tissue on top of the teeth. The crown of the tooth cannot be cleansed properly and accumulates bacteria. ADA definition: “Occlusal surface of tooth covered by soft tissue; requires mucoperiosteal flap elevation.”
Partial bony impaction | In this case, the wisdom tooth only partially erupts through the jaw bone and may or may not be visible through the gums. The tooth cannot fully erupt to aid in the chewing process which creates a periodontal pocket with plaque and decay. ADA definition: “Part of crown covered by bone; requires mucoperiosteal flap elevation and bone removal.”
Complete bony impaction | There is no space at all for the tooth to erupt, so it remains embedded in the jaw bone. The tooth will most likely not be visible in the mouth. This type of impaction can be more difficult to remove since the impacted tooth is deeper. The deeper the impaction, the more complicated the surgery and the more the post-operative discomfort. ADA definition: “Most or all of crown covered by bone; requires mucoperiosteal flap elevation and bone removal. ”
Severe complete bony impaction | These are the most complicated impactions They are typically close critical and vital structures such as nerves and sinuses that require additional care during their removal. Majority of these cases requires a 3D CBCT prior to the surgery to better determine the location of critical structures. ADA definition: “Most or all of crown covered by bone; unusually difficult or complicated due to factors such as nerve dissection required, separate closure of maxillary sinus required or aberrant tooth position.”
Dr. Massoomi of San Francisco Surgical Arts will help you assess your situation and decide if wisdom teeth removal is right for you. He will ensure that your procedure is precise and virtually painless, so that you can enjoy a healthy smile soon after your visit. To learn more, please give us a call today!