Impacted wisdom teeth are the teeth, which are unable to erupt in the oral cavity. One of the main reasons is the lack of area for eruption due to presence of adjacent teeth. A wisdom tooth can be called as an impacted one when the ratio of the size of the erupting wisdom teeth and the size of the patient’s jaw is not normal. Wisdom teeth cause inflammation and pain while erupting into the mouth. If it does not get enough space to develop, it can also harm the adjacent normal teeth.
Usually the teeth are classified into 4 types: developing, erupted, embedded and impacted. Out of these, impacted ones are more complicated and require proper dental care and handling by dental professionals. The direction of the teeth, depth of impaction and the amount of available space for tooth eruption are the factors which determine the level of impaction of the particular tooth. This also helps to diagnose the fact whether the patient’s impacted teeth are due to some disease or not. X-rays are highly recommended in order to see the position and direction of the teeth and determine the treatment route for that particular tooth. Presence or absence of any kind of disease, especially a dental disorder can also help to determine the reason of impaction of wisdom teeth. Based on the direction, impacted wisdom teeth can be classified as distoangular impacted teeth, vertical impacted teeth, mesioangular impacted teeth and horizontal impacted teeth. Age plays an important role when a dental surgeon treats the patient for the impacted wisdom teeth.
Signs and symptoms of the impacted teeth highly depend on the way they affect the adjacent teeth and oral cavity. If an impacted tooth has not affected adjacent teeth, has caused no inflammation in the mouth and has no pathology then signs and symptoms will be rarely associated with such a tooth. Moreover, it is important to note that most of the individuals are asymptomatic in cases of impacted wisdom teeth. Some of the most common symptoms in impacted wisdom teeth are bad breath, bleeding from gums swelling & pain. Periocoronitis i.e. inflammation around the crown of the teeth leads to bleeding of the gingiva and bad breath. Many a times, pericoronitis can be associated with none of the above symptoms. So it’s better not to consider lack of symptoms as absence of disease in case of impacted wisdom teeth. There 2 main reasons of occurrence of impacted teeth. One is that there is a lack of space in the jaw for the wisdom teeth to erupt and the second is mainly associated with the genetics.
Pathophysiology of an impacted wisdom tooth varies with age. An individual of a 20 year and above age group will have pericoronitis associated with the wisdom teeth. Dental caries in the posterior teeth, especially the second molars are also seen in such patients. Patients in the age group of 40, have very little chance of having a benign neoplasm around an impacted wisdom tooth. This shows that with age the chances of tumor formation decrease.
Impacted wisdom teeth removal
Impacted wisdom teeth are the teeth, which is unable to erupt in the oral cavity due to the presence of the adjacent normal teeth. Due to this, there is pain and swelling most of the times. To treat this, dental surgeons usually choose the option of impacted wisdom teeth removal i.e. extraction, so that the patient can get rid of the tooth and the pain and disturbance associated with it. When a tooth is fully erupted then the surgeon doesn’t face any problem and he can treat the tooth like any other normal teeth. But if the teeth are unable to erupt and has operculum of gingiva around it, then it is challenging for the surgeon to remove it from the oral cavity. The impacted tooth has to be removed for sure when there is a disorder associated with the tooth or the there are symptoms which can be seen with the presence of the impacted wisdom teeth.
An impacted wisdom tooth cannot be removed straight away by the surgeon. It takes a couple of measures and steps to be followed so as to remove the teeth with care without harming the adjacent tooth. If the impacted tooth is surrounded by operculum of gingiva, then the patient is asked to rinse mouth with an antiseptic mouthwash to prevent further spread of any gingival infection. In sever cases, the patient is given antibiotics to stable the condition and prepare for the procedure. The procedure is quite sensitive and can a long period of time depending on the age of the patient. So it’s important to have local anesthesia or even general anesthesia ready with the dental assistants. A part of the maxilla or mandible or maxilla wherever the impacted tooth is present is cut in order to make space for the removal of the impacted wisdom teeth. The impacted cannot be removed as a whole tooth. It is divided into pieces and then one by one the pieces are taken out. Extra care has to be taken by the surgeon to avoid any damage to the inferior alveolar nerve present, even by mistake.
After the removal of the impacted teeth, there will be lots of pain in that area, especially in the area of the extracted teeth. Many a times, there is excessive bleeding in the patient’s mouth. In order to prevent the occurrence of excessive bleeding patient’s medical prescriptions should be checked for any intake of anti-coagulants or blood thinners on a regular basis can lead to the increased blood loss. If a patient is diabetic then the patient has to be taken extra care than the normal patient to avoid any kind of complications. For this, the physician of the patient should be consulted and asked for a consent form permitting the dental extraction. Usually, such patients are not suggested for a tooth extraction procedure by keeping note of their health status. Even the pregnant ladies are taken more care and usually not advised to undergo a tooth extraction procedure. This is due to the reason that during pregnancy, there are various hormonal changes in the body which causes more bleeding after such procedures.