Friday, May 1, 2015

Warning Signs Impacted Wisdom Teeth

Oral surgery extraction at dental office
Impacted Wisdom Tooth

Wisdom teeth can have a mind of its own.  For the majority of people, they usually erupt from 17 years to 21 years of age.  Sometimes they don't develop at all, but when wisdom teeth (also known as 3rd molars) develop and erupt, they can cause pain and swelling.  Often times their may not be enough room for the wisdom teeth to erupt normally.  If there is not enough room for the wisdom teeth to come about, they are considered impacted, and which later on can cause issues.

There are two types of wisdom teeth impaction:

  • SOFT TISSUE IMPACTION: When wisdom teeth attempt to erupt with insufficient room, the gums surrounding the tooth may be red, inflamed, puffy, and sore.  The gums may even bleed and  be painful to touch.
  • HARD TISSUE IMPACTION: In some cases wisdom teeth may be positioned at a horizontal or semi-vertical angle.  These teeth may look like they are on the path to hit the adjacent tooth, possibly causing damage (external resorption or decay) to the tooth in front.

What are warning signs of impacted wisdom teeth to look out for?

  1. There is a constant dull ache coming from the very back of your upper and lower teeth.  This ache may progress to severe pain that may radiate down the lower jaw, or up towards the sinus and temple of the forehead.  This pain may be suggestive of hard tissue impaction.
  2. Your dentist takes a x-ray that shows the wisdom tooth is causing tooth decay and resorption (tooth damage) to the tooth in front.
  3. You look in your mouth and see that the gums directly behind your last molars is swollen, puffy, and painful to touch.  The gums may also bleed to touch or by itself.

Treatment of impacted wisdom teeth:

  • Palliative treatment - Sometimes pain from wisdom tooth impaction can be managed by a warm moist towel and non-steroidal medication (NSAIDS) such as ibuprofen or aspirin.  Such treatment is usually temporary however.
  • Extraction - If the wisdom tooth is causing damage to the adjacent teeth, or palliative treatment is not able to provide relief, your dentist or oral surgeon would surgically remove the offending wisdom tooth. Extraction would also be required in soft tissue impaction cases where the gingival tissue continues to remain swollen and painful if due to the wisdom tooth.
  • Doing nothing - A curious choice this may be, but because wisdom tooth movement can be so unpredictable, their movement may suddenly stop, thus halting the pain.  This may be a suitable conservative "watch and see" approach in milder cases.

If you have any questions regarding impacted wisdom teeth, be sure to consult your family dentist or oral surgeon.

Warm Regards,

Peter Chien, DMD, MPH