Impacted wisdom teeth is a disorder where the third molars (wisdom teeth) are prevented from erupting by a physical barrier, usually other teeth. If the wisdom teeth do not have an open connection to the mouth, pain can develop with the onset of inflammation or infection or damage to the adjacent teeth.
Wisdom teeth likely become impacted because of a mismatch between the size of the teeth and the size of the jaw. Impacted wisdom teeth are classified by their direction of impaction, their depth compared to the biting surface of adjacent teeth and the amount of the tooth's crown that extends through gum tissue or bone. Impacted wisdom teeth can also be classified by the presence or absence of symptoms and disease.
Screening for the presence of wisdom teeth often begins in late adolescence (age 15-17) when a partially developed tooth may become impacted. Screening commonly includes clinical examination as well as x-rays such as panoramic radiographs.
Infection resulting from impacted wisdom teeth can be initially treated with antibiotics, local debridement or soft tissue surgery of the gum tissue overlying the tooth. Over time, most of these treatments tend to fail and patients develop recurrent symptoms. The most common treatment is wisdom tooth removal by an Oral & Maxillofacial Surgeon.
The risks of wisdom tooth removal are roughly proportional to the difficulty of the extraction. The most common risks are temporary; dry socket, minor infections and bleeding. Less common risk that can persist include injury to the nerve that allows you to feel your lower chin, teeth, gums or tongue, or a hole between the sinus and the mouth that requires a second procedure to close.
Sometimes, when there is a high risk to the, only the crown of the tooth will be removed (intentionally leaving the roots) in a procedure called a coronectomy. The long-term risk of coronectomy is that chronic infection can persist from the tooth remnants.
One of the primary reasons for removal of wisdom teeth is to save the 2nd molars from irreparable harm. The prognosis for the second molar is good following the wisdom teeth removal with the likelihood of bone loss after surgery increased when the extractions are completed in people who are 25 years of age or older.
The condition affects up to 72% of the Swedish population. Wisdom teeth have been described in the ancient texts of Plato and Hippocrates, the works of Darwin and in the earliest manuals of operative dentistry. It was the meeting of sterile technique, radiology and anaesthesia in the late 19th and early 20th centuries that allowed the more routine management of impacted wisdom teeth.
