Impacted Wisdom Teeth

Wisdom teeth are the last (third) molars to emerge from the gums, and typically appear when a person is between the ages of 16 and 25 — presumably a "wise" age range. There are usually four wisdom teeth, although some people have more and some have fewer.

Because they come in after all the other teeth, there is not always enough room left for them. Then they become impacted — meaning that they are unable to fully emerge because of the neighboring teeth being in the way, or because they are wrongly angled. When that happens, oral surgery may be necessary.

Types of Impaction

Most often the impacted tooth is angled diagonally forward, known as mesial impaction. This pushes it against the next molar towards the front of the mouth. In other cases, it may be:

• Angled upwards correctly, but unable to fully emerge through the gum tissue (vertical impaction)
• Angled horizontally, trying to erupt sideways against the next tooth (horizontal impaction)
• Angled backwards towards the back of the mouth (distal impaction)
• Fully surrounded by the jawbone (bony impaction)
• Through the bone but unable to erupt through the gum tissue (soft tissue impaction)

When the wisdom tooth is still inside the bone or gums, there is usually less problem with it and perhaps no oral surgery to extract it would be necessary. However, when it has partially emerged through the gum tissue, the problem arises of dental hygiene.

Plaque Around a Partially Erupted Wisdom Tooth

Once the tooth breaks through the gum surface, the problem is how to keep it clean. Around each tooth’s crown (the visible part), between it and the surrounding gum tissue, is a small space (a pocket). This is true even of the tooth still inside the gums because gum tissue never attaches itself to a tooth’s crown. When part of the tooth becomes visible, bacteria have an opening where they can spread down under the gums, into this pocket around the rest of the impacted tooth.

Plaque — that sticky film which accumulates on the tooth if they are not regularly brushed — consists of bacteria and their acid excretions. When plaque remains too long on the teeth, decay and infection set in. This is the first stage of gum disease (gingivitis). In the case of an impacted tooth, the same thing happens and dentists call it pericoronitis.

Since most of the tooth’s crown is still inside the gums, there is no access for cleaning it, yet the tiny bacteria have access through the pocket opening. If the impacted tooth is leaning against a neighboring tooth, decay can spread to that tooth also.

Oral Surgery Now Necessary

Gum disease now has an open door to spread into the gums and bone. Wherever bacteria can make a home, multiply, and deposit their acid excretions, decay happens and infection spreads. The only recourse is to remove the impacted tooth. Dr. Coleman is a practiced oral surgeon. By extracting the impacted wisdom tooth, he can give the rest of your teeth more room, prevent any cysts from developing around the impacted tooth, and improve your overall dental health.

Each case of an impacted wisdom tooth is individual. If you have any of this problem, he will examine your mouth and discuss the options with you. Age is a factor sometimes, in how complex the procedure might be. Generally, the age range of 18 to 24 years is considered the best, but this oral surgery can be done at other times too.

Please contact our San Diego offices if you would like to know more about wisdom teeth and whether they should be extracted. Our modern dental equipment and training makes all dentistry easier, faster, and more pain-free than dentistry in past years.

We also offer sedation dentistry if you have dentist anxiety. We will be glad to arrange a complimentary consultation for you, and you can bring all your questions. We hope to meet with you soon.