Wisdom tooth impaction during eruption can be the source of dental complications such as overcrowding, pain, and infection which can necessitate the need for wisdom tooth extraction or other dental treatments to alleviate the problem and keep the remaining teeth healthy. Wisdom teeth, also called third molars, are located at the back of the upper and lower jaw on either side of the mouth and typically erupt between the ages of 17 and 24.

Your dentist, however, can detect (through panorex x-rays) the positioning of the wisdom teeth under the gums before they ever begin to erupt. In this way, he/she can foresee potential problems that may need to be addressed before the wisdom tooth eruption process progresses too far, which can sometimes create more serious dental issues. Early removal of problematic wisdom teeth is recommended, as their roots are not completely formed and the jaw bone is less dense in younger patients.

Wisdom Tooth Impaction Video

The Pacific Oral Surgeons are members of the American Association of Oral and Maxillofacial Surgeons (AAOMS). AAOMS has provided our patients with an informative and educational video on the management of wisdom teeth.

Signs of Wisdom Tooth Eruption

As with any tooth eruption, there can be some discomfort as the wisdom teeth begin to make their way through the gums. Because the gums become thicker as we age, wisdom tooth eruption is usually more painful than the tenderness felt when previous molars (such as 12-year molars) emerged.

Symptoms of wisdom tooth eruption can include:

• Swelling and/or pain in the jaw, cheek, or adjacent tissue
• Chewing difficulty
• Trouble opening the mouth wide
• Tingling in the cheeks when resting on the hands or a pillow
• Red, irritated gums
• Sensitivity to cold
• Headache

 Pain and Wisdom Tooth Impaction

Wisdom tooth pain can be a sign of impaction, so careful monitoring by your dentist is important in order to intercept possible complications.

Impacted Wisdom Teeth

Wisdom tooth impaction occurs when the tooth fails to properly or fully erupt into its proper position.

Causes of wisdom tooth impaction can include:

• Obstruction of the eruption path by other teeth
• Insufficient room in the jaw for the wisdom teeth to fully erupt
• Improper angulation (the tooth is coming in incorrectly)

Classifications of Wisdom Tooth Impaction

Impacted wisdom teeth are classified by their positioning (or angulation) within the jaw.

• Mesial (or mesio-angular): This is the most common angulation in which the wisdom tooth angles toward the front of the mouth.
• Vertical: The wisdom tooth is erupting at the proper angle, however, the jaw does not have sufficient space to accommodate the tooth.
• Traverse (or horizontal): The wisdom tooth is lying sideways under the gum.
• Distal (or disto-angular): The impacted tooth angles toward the back of the mouth.

In addition to angulation, impacted wisdom teeth are categorized by their location in the jaw bone (how far they have erupted).

Additional impaction categories include:

• Soft tissue impaction: The crown of the wisdom tooth (upper portion) has erupted through the bone but not fully through the gums.
• Full bony impaction: The wisdom tooth lies encased completely within the jaw bone.
• Partial bony impaction: The wisdom tooth lies within the bone but has begun to emerge partially.

While wisdom teeth can properly erupt without causing any dental problems, research suggests that over 65% of people will incur at least one impacted wisdom tooth. Impaction is more likely to occur with lower wisdom teeth than with upper.

Symptoms of Impacted Wisdom Teeth

It is possible for impacted wisdom teeth to be asymptomatic, however, the more common occurrence is that the patient experiences worsening symptoms which are often due to infection or other problems caused by the impaction.

Common symptoms of wisdom tooth impaction include:

• Throbbing pain at the site of eruption: Impacted wisdom tooth pain typically radiates from the back of the mouth. As other teeth are affected, pain usually intensifies.
• Jaw swelling: The jaw can swell to the point that opening the mouth can be difficult.
• Swollen, bleeding, or tender gums: Impacted wisdom teeth can cause the gums to be swollen and tender to the touch, making brushing and flossing painful. Bleeding may occur when pressure is applied.
• Swollen glands in the neck or shoulder: Impaction often affects the patient’s glands, particularly if wisdom tooth infection is present.
• Frequent headaches: The temporomandibular joint (TMJ) connects the skull to the jaw, therefore, wisdom tooth pain often radiates to the head and/or face.
• Bad breath or bad taste in the mouth: Bacteria can become trapped around the impaction area and produce an unpleasant odor.

If left untreated, an impacted wisdom tooth can cause:

• Gum disease: Impacted wisdom teeth often become infected or decayed which can spread to the gums. Even properly erupted wisdom teeth are susceptible to bacteria and decay due to their location making cleaning more difficult.
• Damage to adjacent teeth: Wisdom teeth improperly emerging can push neighboring teeth out of alignment and subsequently change a patient’s entire dentition (the way the teeth come together). Impacted wisdom teeth can also damage the roots of second molars by their positioning or by spreading decay/infection.
• Cysts: The sac within the gum line which houses the wisdom tooth can become fluid-filled during impaction and form a cyst. Cyst formation can damage nerves, as well as adjacent teeth.

Wisdom tooth extraction is the typical treatment for an impacted wisdom tooth. If you are experiencing symptoms of an impacted wisdom tooth, contact your dentist for an evaluation. If you have been diagnosed with an impacted wisdom tooth and would like more information concerning treatment/extraction, please contact our office for a consultation.

If you would like to arrange a consultation with a doctor at Pacific Oral Surgery, please submit an online appointment request or call one of our Pacific Oral Surgery offices located in Ventura, Thousand Oaks and Simi Valley.

Our team of oral, maxillofacial and dental implant surgeons, Dr. James Jacobs, Dr. John Webb, and Dr. Sebastian Carlson, welcomes you to our Pacific Oral Surgery practice.