Dr. Martin R. Aidelbaum Inc.

Impacted wisdom teeth

When a wisdom tooth is blocked from erupting or coming into the most normally, it is termed "impacted".  A tooth may be only partially impacted, meaning it grows in crooked and breaks through the gum only partially, or it may fail to breakthrough at all. and thus remains totally impacted.  Serious problems can develop from partially impacted teeth, such as pain, infection, and crowding out, or damage to, adjacent teeth. for totally impacted teeth, more serious problems can occur if the sac that surrounds the impacted tooth fills with fluid and enlarges to form a cyst.  This enlargement can hollow out the jaw and result in permanent damage to the teeth, jaw bone nerves.  If the cyst is not treated, a tumor may develop from the walls of the cyst and a more involved surgical procedure may be  required for removal.  Many problems with wisdom teeth can occur with few or no symptoms, so there can be damage without your knowing it.  It is important to know that as wisdom teeth develop their roots become larger and the jawbone more dense, as a person grows older, it becomes more difficult to remove wisdom teeth and complications can become more severe.  In addition, as people age there is an increase chance of the symptoms mentioned above.  For these reasons, the surgeon may recommend the removal of wisdom teeth even if they're not yet causing obvious problems, particularly for young adults.

How wisdom teeth are treated

Treatment of impacted wisdom teeth involves their removal using special surgical techniques appropriate for each individual case.  The dentist who has specialized training in the removal of wisdom teeth is called an oral and maxillofacial surgeon.   If the wisdom teeth have fully erupted in normal position, they may be observed by your dentist during your regular visits to ensure they are properly cleaned and no problems are developing such as decay.  Minor abnormalities in the position of interrupted wisdom tooth may be taken care of by your dentist or removal might still be best.  The removal of wisdom teeth can be performed on an outpatient basis, either in the dental office or in certain cases in a hospital setting.  If the tooth is impacted, an incision is made in the gum tissue and the tissue is turned back so the teeth can be seen.  If bone is covering the tooth, it may need to be removed in order to expose and extract the tooth.  The tooth may be removed whole, or in some cases it may be cut into sections and each section is then individually removed.  Usually the surgical procedure will take up to 30 minutes, although this varies according to each case.   After surgery you will spend sometime in "recovery" before going home.   In most cases normal activities can be resumed within a few days depending on the degree of impaction and the number of teeth removed.

Risks and complications

The removal of wisdom teeth is a common procedure that usually produces few, if any, serious complications.  However as with any surgical procedure you should be aware of possible complications and discuss them with your surgeon prior to consenting to surgery.   Following are potential complications you should understand:

1. infection any time body tissues are invaded, as in surgery, there is a slight chance of infection setting in afterwards.  Any infection should be taken seriously and reported to your surgeon, who will prescribe appropriate antibiotics to eliminate the problem.  Signs of infection to watch for include fever, abnormal swelling and pain, salty or prolonged bad taste and pus information

2. Injury -- damage to fillings in adjacent teeth, to the teeth , to bridge work, or to surrounding bone can potentially occur.

3. Dry socket -- this term is used to describe a condition that can develop in the empty tooth socket, when normal blood clotting is disturbed following surgery.  If a blood clot does not form properly in the socket for some reason, for example smoking or food impaction, the socket remains "dry" for a period of time and heals more slowly than usual.  The dry socket can be quite painful because it leaves the bone within the socket exposed in air, food and fluids.  If you experience such pain within a few days following surgery, contact your surgeon.  Steps can be taken to reduce discomfort while healing takes place.

4.  Numbness -- in some cases major sensory nerves serving the mouth are in close proximity to wisdom teeth, and it is possible that one or more of these nerves may be injured during surgery.  If this happens, Paraesthesia or anesthesia can result which means partial or total loss of feeling in the areas served by the nerve.  This numbness tingling or funny feeling can affect... the cheek, chin, gums or teeth depending on the nerve that is involved.  Usually the numbness does not occur,  when it does occur it is usually temporary but in some  cases in may be permanent.