Impacted wisdom teeth

Diagnosis

Your dentist will conduct a thorough examination of your teeth and mouth to identify any potential issues, such as impacted wisdom teeth. This examination typically involves:

• Asking about your dental symptoms and overall health.
• Assessing the condition of your teeth and gums.
• Performing dental X-rays to detect impacted teeth and signs of tooth or bone damage.

By conducting these assessments, your dental professional can diagnose any problems and recommend appropriate treatment.

Treatment

If managing your impacted wisdom teeth poses challenges or if you have medical conditions that might increase surgical risks, your dentist may recommend consulting an oral surgeon. The oral surgeon can engage in discussions with you regarding the most appropriate course of action. 

Managing wisdom teeth without symptoms

There is disagreement among dental specialists regarding the removal of asymptomatic wisdom teeth, which are those not currently causing symptoms. A considerable number of dental specialists advocate for the extraction of asymptomatic wisdom teeth during the late teens to early twenties, as this age range is associated with lower complication risks, and the procedure is generally safer and better tolerated by younger individuals.

Certain dentists and oral surgeons recommend preemptive removal of wisdom teeth, even in the absence of current issues, to avert potential future complications. Their rationale is:

• In cases where there is insufficient space for proper emergence, accessing and cleaning these teeth can be challenging.
• Asymptomatic wisdom teeth may still harbor underlying diseases.
• The procedure becomes more challenging with age, increasing the likelihood of potential complications later on.
• Severe issues with wisdom teeth are less common in younger adults.

Alternative viewpoints from additional dentists and oral surgeons advocate for a more cautious strategy. They highlight that:

• Currently, insufficient evidence supports the idea that impacted wisdom teeth, without ongoing issues in young adulthood, will lead to problems later on.
• The costs and risks associated with the procedure may not warrant the anticipated benefits.

In adopting a conservative approach, your dentist monitors your teeth for signs of decay, gum disease, or any other issues. If problems arise, your dentist might suggest the extraction of the affected tooth.

Surgical removal of wisdom teeth

Typically, impacted wisdom teeth causing pain or other dental issues are addressed through a surgical procedure known as extraction. The extraction of a wisdom tooth is usually necessary for:

• Tooth decay in wisdom teeth that have partially emerged.
• Presence of cysts or tumors associated with the wisdom teeth.
• Infection or periodontal disease affecting the wisdom teeth.
• Infection or periodontal disease affecting the wisdom teeth.
• Proactive measures to prevent future complications.
• Wisdom teeth causing damage to adjacent teeth.

Extraction is primarily conducted as an outpatient procedure, allowing you to return home on the same day. The process involves:

• Sedation or anesthesia. Local anesthesia, which numbs your mouth, may be administered. Alternatively, sedation anesthesia can be provided to reduce awareness, or general anesthesia may be administered to induce sleep.
• Tooth removal. In the course of an extraction, your dentist or oral surgeon makes an incision in your gums and removes any obstructing bone to access the impacted tooth root. Following the extraction, the dentist or oral surgeon typically proceeds to close the wound.

Experiencing pain, bleeding, and swelling, including jaw swelling, is common after wisdom tooth extractions. Temporary difficulty in opening the mouth widely may occur due to swelling of the jaw muscles. Guidelines on wound care, pain management, and swelling reduction, including the use of pain medication and cold compresses, will be provided.

In rare instances, some individuals may encounter:

• Painful dry socket, characterized by bone exposure if a blood clot fails to form or dislodges from the socket post-surgery.
• Potential harm to adjacent teeth, nerves, jawbone, or sinuses.
• Socket infection resulting from bacteria or trapped food particles.