In this article, we will look at all of the aspects related to impacted wisdom teeth, and how to best manage the dental illnesses they might cause. We will touch upon the topic of impacted teeth from a number of different angles. You will learn about impaction types, associated illnesses and dental conditions, extraction procedures, risks, and costs.
You will also learn what factors you should take into consideration before making the decision to extract your wisdom teeth. By the end, we hope that you will have a better overall understanding of the challenges presented by impacted wisdom teeth.
The Impacted Wisdom Teeth Debate
Treating impacted wisdom teeth diseases and conditions is a difficult, and rather controversial, part of dentistry. Problems with impacted wisdom teeth can range from very mild to severe. The diversity of medical conditions which can arise is great. Recent scientific research shows that there are complications that can arise both from removing or not removing impacted wisdom teeth.
The necessity of extracting impacted wisdom teeth no matter what has recently come under attack by dentists. Many dental specialists advocate wisdom tooth retention whenever feasible. Indeed, the evidence seems to suggest that sometimes, you should leave impacted wisdom teeth alone. In many cases, extraction by default can cause more harm than good.
In any case, you should always make an informed decision on whether your particular condition demands tooth extraction or not.
Wisdom Teeth: Basic Definitions
What are wisdom teeth?
Wisdom teeth are the third molars in the human dentition. They are the last teeth to erupt in the back of your mouth. They are somewhat of an anatomical anomaly of the human body. According to most scientists, they are biological relics. Our ancestors used to eat large quantities of cellulose-rich plant matter, so they needed a third molar to facilitate chewing.
As man evolved and became specialized in hunting and primitive agriculture, the human diet changed drastically. There was no longer a need to consume low-energy plant matter. As such, the size of the human jaw decreased with time. However, for unclear reasons, the third molar did not follow through with this change, and remained an integral part of the human dentition.
Due to less space being available, third molars began growing in unnatural positions, which were often detrimental to dental health. Today, some people no longer grow the third molar. However, wisdom teeth are still prevalent in a large majority of the human population.
When do wisdom teeth appear?
Wisdom teeth usually tend to appear between the age of 18 and 26 (hence “wisdom” teeth), but may erupt sooner or later than that. People usually have four wisdom teeth (one for each side of the jaw).
What are impacted wisdom teeth?
The problems wisdom teeth can cause are extremely varied, but mostly depend on impaction – the way in which the tooth develops inside the mouth. Unnatural positions of the wisdom tooth can cause damage to other teeth, to the bone, and the soft tissue. They can also be a catalyst for infection and nerve damage, sometimes with serious health consequences.
It is the different types of impacted wisdom teeth that we must now turn to, in order to better understand what you should do in your particular case.
Impacted Wisdom Teeth: Impaction Types and Symptoms
A tooth is impacted when it has failed to erupt properly, and, consequently, does not assume a correct position. Wisdom tooth impaction is classified in two ways: the orientation of the tooth and the position relative to the jawbone.
In terms of orientation, wisdom tooth impaction can be:
- Mesio-Angular. The most common case, this type of impaction means that the wisdom tooth is pointing towards the front of the mouth. As such, the tooth in question is “leaning” on the second molar.
- Vertical. The wisdom tooth is pointing upwards, in a more or less correct fashion.
- Horizontal. The wisdom tooth is on its side, growing towards the second molar at an angle of roughly 90 degrees.
- Distal. The wisdom tooth is growing towards the back of the mouth.
Position to the Jawbone for Bony Impacted Wisdom Teeth
In terms of position relative to the jawbone, bony impacted wisdom teeth can be:
- Soft-Tissue. Here, the wisdom tooth partially erupted through the gum, but is still mostly enclosed in bone.
- Partial-Bony. In this case, the wisdom tooth has somewhat erupted from the bone tissue, but not from the gum tissue.
- Full-Bony Impaction. The wisdom tooth is fully enclosed in bone.
Impacted wisdom teeth can exhibit any of these characteristics, with different and often unpredictable consequences for oral and overall health. All types can be highly problematic, depending on how much they affect bone, gum, and tooth tissue around them.
Impacted wisdom teeth most often cause pericoronitis, which is a type of gum infection. It is most common in cases of soft-tissue and partial bony impaction, as the tooth damages gum tissue, and allows food and bacteria to accumulate in the small spaces it creates. These spaces are extremely difficult to clean, making pericoronitis a strong case for extraction.
Impacted wisdom teeth can also damage the second molar, by pushing into its roots and/or enamel, thus creating favorable conditions for tooth decay and infection. In extreme cases, the wisdom tooth might damage the bone itself, which is possible in a distal impaction.
In many cases, these types of impaction cause a variety of symptoms, including, but not limited to, tooth pain, swelling, low jaw functionality, ear pain, and headaches. All of these can cause a significant drop in your quality of life, and can make the case for extraction.
It is important to note that not all impacted wisdom teeth are symptomatic. A horizontal full bony impaction might remain asymptomatic for many years, for instance. However, this is not a guarantee that the area is disease-free.
Should you find yourself in any of the above situations, it is up to your dentist’s experience and skill to determine whether an extraction is necessary.
Impacted Wisdom Teeth Removal: To Extract or not to Extract
Some of the most important situations that would possibly require extraction are as follows:
- Pericoronitis and gum disease. The impacted tooth can cause gum inflammation, which can lead to severe infection. In some forms of impaction, the gum line itself might suffer, and could cause destructive gum disease.
- Tooth decay, infection, and/or damage to other teeth. Cavities can appear due to the wisdom tooth pushing against the adjacent molar. In order to prevent the destruction of both teeth, the wisdom tooth should be removed.
- Severe pain. Impaction is often associated with severe pain. If persistent and highly damaging to one’s quality of life, the wisdom tooth should be removed.
- Tooth crowding. The theory that wisdom teeth cause “tooth crowding” in front of the mouth is rather controversial. Despite conflicting evidence, is it reasonable to assume that impacted wisdom teeth cause at least some crowding in adjacent teeth.
However, it is very important to remember that not all impacted wisdom teeth should be extracted. In some cases, extraction can do more harm than good, especially if the procedure is extremely invasive and involves damage to the bone tissue. If the wisdom tooth is impacted, but so far asymptomatic, your dentist might recommend the “wait and see” tactic rather than push for surgery.
To make matters more complicated, some impacted wisdom teeth have roots which are dangerously close to key nerves in your lower jaw. If the nerve is damaged during the extraction, it might cause you to lose all sense to the lower jaw.
Bony Impaction vs. Partial Impaction
New evidence points to the fact that a full bony tooth impaction is less likely to cause problems, even if it might look worrying in your x-rays. If the tooth has fully developed and is encased in bone, bacteria and other particles cannot reach the tooth. Thus, the tooth is relatively safe from infection. This type of impaction may cause cysts and tumors, but the incidence of such complications is quite low. Their extraction, however, is very complicated, as it means that the surgeon must remove part of your jawbone.
Besides the risk of nerve damage, there is also a chance that the empty tooth socket will develop a “dry socket”, where your jawbone is directly exposed to the oral environment. It’s not even worth mentioning that this would entail highly unpleasant complications.
If impacted teeth are not extracted, you should nevertheless keep under constant observation. You should report any discomfort or symptom to your dentist.
By contrast, soft-tissue and partial impactions are much more likely to cause problems. That’s because the impacted wisdom teeth are exposed to decay, and are more prone to damage other teeth.
Regardless of which case applies to you, extracting your impacted wisdom teeth is a decision you should not take lightly. It requires a great deal of reflection on the entire set of complicated medical variables in play.
Impacted Wisdom Teeth: Extraction Procedures and Costs
Depending on the type of procedure, wisdom teeth extraction costs can be anywhere between $200 to $600 per tooth. These figures do not include other auxiliary costs.
- For a soft tissue impaction, the price would be the lowest, at somewhere between $200 and $400 per tooth. The procedure involves making an incision in the gum and extracting the tooth. Depending on the tooth’s position, patients might need special cutting procedures. The dentist will cut and remove the tooth piece by piece. The gums will be stitched back together after the procedure.
- In the case of a partial bone or full bone impaction, the procedure will involve the removal of bone in order to access the impacted tooth. The doctor needs special tools and conditions. This procedure is at the intersection of dentistry and maxillofacial surgery. The cost, therefore, will also be higher, with as much as $600 per tooth.
A properly managed recovery is also very important. Read more about wisdom teeth and what to eat to ensure a quick recovery in this informative article.
In conclusion, it is very difficult to make a decision concerning impacted wisdom teeth removal without expert dentist advice. There is no general recommendation for impacted wisdom teeth. Thus, your dentist should analyse your particular case. Regardless of what you decide, remember to only seek the very best medical advice before engaging in such a procedure.