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Wisdom teeth also referred to as third molars usually erupt between 17-25 years of age. Anthropological studies show that wisdom teeth erupt in order to compensate for the excessive wear and forward drifting of teeth due to the rough diet of early humans. Modern diet is soft and refined and excessive wear of teeth is not observed. As a result there is no room for wisdom teeth to erupt. This causes the wisdom teeth to get impacted.

What is an impacted tooth?

A tooth becomes impacted when there is a lack of space in the dental arch and its growth and eruption are prevented by overlying gum, bone or another tooth. A tooth may be partially impacted, which means a portion of it has broken through the gum, or totally impacted when it is unable to break through the gum at all.

What are the problems associated with impacted wisdom teeth?

Horizontal
Vertical
Mesio Angular
Disto Angular


Maxillary
Erupted Tooth (Mandibular)
Erupted Tooth (Maxillary)


There are numerous problems depending on the type of impaction. Partially impacted wisdom teeth cause the overlying gum tissue to become inflamed and irritated. There will be food lodgment in the area which will eventually lead to decay on both the wisdom tooth and the tooth next to it .Failure to remove the wisdom tooth in a timely manner will necessitate root canal treatment on the tooth adjacent to it. Also the area can get infected and the infection can spread to the muscles that help to open and close the mouth leading to restricted opening of the mouth, stiffness and illness. The pressure from the erupting wisdom tooth may move other teeth and disrupt the alignment of teeth.

When the wisdom tooth is totally impacted the developmental sac that surrounds the tooth becomes filled with fluid and enlarges to form a cyst. As the cyst grows it may hollow out the jaw and permanently damage adjacent teeth, the surrounding bone and nerves. Rarely, if a cyst is not treated, a tumor may develop from its walls and a more serious surgical procedure may be required to remove it. Sometimes the wisdom teeth make their way through the gum tissue but due to lack of space may erupt more buccally (towards your cheek) or ligually (towards your tongue). This causes cheek biting, food lodgment, subsequent decay and infection.

Early removal is recommended to avoid such problems and to decrease the surgical risks involved with the procedure.

How early should wisdom teeth be removed?

Wisdom teeth are easier to remove when the patient is younger, since their roots are not completely formed, the surrounding bone is softer, and there is less chance of damaging nearby nerves or other structures. Removal of wisdom teeth at a later age becomes more complicated as the roots have fully developed (may involve the nerve), and the jawbone is denser. Also early removal will ensure optimal and less complicated healing. For some patients the wisdom teeth may erupt normally and will be properly aligned in the arch. In such instances the wisdom teeth can be retained with proper home care.

Procedure for removal of wisdom teeth

Most wisdom tooth extractions are performed in the oral and maxillofacial surgery office under local anesthesia, intravenous sedation or general anesthesia. Your oral and maxillofacial surgeon will discuss the anesthetic option that is right for you.

The extent of the procedure depends on the tooth position, degree of impaction and root development. Once adequate anesthesia is achieved an incision is made in your gums adjacent to the probable location of the wisdom tooth to be removed. The gum tissue overlying the impacted tooth is reflected. Removal of some bone around the tooth may be necessary to free the tooth and aid in a non-traumatic extraction. Resorbable sutures may be placed.