Warning Signs Impacted Wisdom Teeth

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
www.bellevuefamilydentistry.com
425-614-1600 

Signs Wisdom Teeth Need Extraction

Impacted Wisdom Tooth

WISDOM TEETH

"Wisdom teeth" can be an anomaly in its own right.  Some people have them and those teeth are just fine.  Others have to put up with the occasional discomfort.  And still others have to deal with persistent throbbing pain.  So how does one know if wisdom teeth need to be extracted?

WHERE ARE MY WISDOM TEETH?

Wisdom teeth are typically the very last molars in the mouth.  Also called third molars, they are usually the most posterior teeth in each quadrant (upper right, lower right, upper left, lower left).  Most adults have four wisdom teeth, one in each quadrant.  In very rare cases, some adults have develop a "fourth molar" which is usually nonfunctional, atypical in shape, and may be located deep beneath the jaw bone.

WHEN DOES MY WISDOM TEETH NEED TO BE REMOVED?

Some common signs and symptoms that wisdom teeth need an extraction include:

• Persistent throbbing and aching pressure adjacent to the wisdom teeth that is not going away.  This may be due to insufficient space for the wisdom tooth to fully erupt.  May be also known as hard tissue impaction, and feel like a toothache, and as such may require emergency dentistry.
• Swollen and bleeding gums directly on top of the wisdom tooth.  This is also known as soft tissue impaction and pericorinitis.
• Wisdom tooth causing tooth decay and cavity to the tooth next to the wisdom teeth.  In some cases the wisdom tooth is erupting at an angle (mesial impaction) causing decay and/or external resorption of the adjacent tooth.  After the wisdom tooth is extracted, the affected tooth may need a filling or root canal and porcelain crown, or even an extraction, depending on the size of the cavity.
• When the wisdom tooth is so far back in the jaw it is hard to keep the area clean, and the tooth has a large cavity that is difficult to restore.
• If the wisdom tooth is difficult to keep clean, there is bone loss that causes the tooth to have periodontal involvement.

WHAT IS THE FUNCTION OF THE WISDOM TOOTH?

Research suggests that humans in the past had larger jaws to accommodate wisdom teeth, and it is thought that the wisdom teeth were used to help with chewing of foliage and plants due to a predominantly plant based diet.  As humans evolved and diets changed that included meat, the jaw decreased in size and wisdom teeth no longer serve its once thought to be designed function for foliage chewing.  The result is wisdom may become impacted, overgrown, and thus need to be either restored or surgically extracted.

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

From your gentle family dentist in Bellevue,
Dr. Peter Chien
www.bellevuefamilydentistry.com
(425) 614-1600