Impacted wisdom teeth happen when your third molars become partially or fully trapped in your gums or jawbone. This can lead to a number of oral health problems, including infection, tooth decay and gum disease. Surgical removal is often recommended as treatment for impacted wisdom teeth.
What are the symptoms of impacted wisdom teeth?
Some people with impacted wisdom teeth won’t notice any problems at all, while others will have obvious symptoms.
An impacted wisdom tooth might break through the gums, and part of the gums can be seen. This is called a partially impacted wisdom tooth.
A partially impacted wisdom tooth may cause food to become trapped and can make cleaning the tooth more difficult. For some people, a partially impacted tooth is very painful.
If the tooth becomes infected or causes other issues, you may have symptoms such as:
- pain or swelling around the jaw
- red, swollen, or bleeding gums
- bad breath
- an unpleasant taste in your mouth
- problems opening your mouth
In other cases, the affected tooth may never break through the gums. This is known as a fully impacted wisdom tooth.
What causes an impacted wisdom tooth?
Generally, wisdom teeth become impacted because your jaw doesn’t have enough space for the teeth. Sometimes, the tooth grows in at the wrong angle, which can cause it to become impacted.
Treatment of impacted wisdom tooth
In most cases where a problem has developed or a high risk of developing the wisdom tooth could be removed completely or part removed. During your consultation these options will be discussed with you in detail along with what is involved and the risks of the procedure. Your upper wisdom teeth may need to be removed as well.
What does the complete removal of wisdom teeth involve?
If the wisdom tooth has not fully erupted into the mouth it is often necessary to make a cut in the gum over the tooth. Sometimes it is also necessary to remove some bone surrounding the wisdom tooth. The tooth may need to be cut into 2 or 3 pieces to remove it. Once the wisdom tooth has been removed the gum is put back into place with stitches. In the majority of cases these stitches are dissolvable and take around two weeks to disappear.
What type of anaesthetic is used?
A number of options are available and depend on how difficult the wisdom tooth is to remove:
Local anaesthetic – this is an injection into gum surrounding the wisdom tooth, rather similar to that you may have had at your dentist for a filling. The injection takes a couple of minutes to numb the area and means that you will feel no pain while the wisdom tooth is removed.
Local anaesthetic and intravenous sedation – in addition to a local anaesthetic injection you can be given an injection into your arm. This makes you feel relaxed and less aware of the procedure. You are awake but patients frequently have little or no memory of the operation.
General anaesthetic – it is usually possible to remove wisdom teeth under a “day case” general anaesthetic, ie although you are put to sleep completely you will be able to go home on the same day as surgery.
What are the main possible risks of removing a wisdom tooth?
Most patients will recover fully with no problems.
There may be a little bleeding at the time of the extraction this usually stops very quickly and is unlikely to be a problem. If you are at home and the area bleeds again this can usually be stopped by applying pressure over the area for at least 10 minutes with a rolled up handkerchief or swab. If the bleeding does not stop, please contact the department where you had your operation.
Altered Sensation to the chin, lower lip or tongue
Two nerves lie quite close to the lower wisdom teeth. The nerves can vary in their proximity to wisdom teeth. The lingual nerve provides sensation in your tongue whilst the inferior dental nerve gives sensation to the lower lip and skin overlying the chin. Occasionally these nerves may be bruised during tooth removal. If this happens then you may have either numbness or pins and needles in either the tongue, lower lip, skin over the chin or any combination of these.
An infection in the in the socket can occur or the blood clot from extraction socket has dissolved away which may result in a dry socket. The incidence of this happening is low being in the order of 2%. It can be minimised by keeping the area clean with rinsing with water or a mouthwash starting this the day after your procedure.
Weakening of the Jaw
In exceptional cases wisdom tooth removal can cause significant weakening of the jaw with the resultant possibility of jaw fracture. The incidence of this happening is extremely low and is less than 1% (less than 1 in 100).
Recovery from impacted wisdom teeth surgery
Most people fully recover from impacted wisdom teeth surgery in three to four days. If your teeth were impacted or came in at an awkward angle, it could take a full week to recover.
The wound left behind after surgery won’t be completely healed for months, so you can still develop an infection weeks after surgery. Take care of yourself and pay attention to any signs of trouble.
You can resume normal, daily activities the day after surgery, but avoid any activity that could dislodge stitches or the blood clot over your wound. This includes, but isn’t limited to:
- strenuous exercise
- drinking from a straw
Some swelling, pain, and bleeding is normal after wisdom teeth removal. Call your dentist immediately if the pain or bleeding is excessive and unbearable.
Your symptoms should be greatly improved by the third day after surgery. All pain and bleeding should be gone within a week of surgery.
The main ways you can manage pain and reduce swelling are by using ice and taking pain medication. Ask your dentist for instructions on how often to use an ice pack on your face. Don’t put ice directly to your face, as this may lead to ice burn. They’ll also recommend whether to take prescription or over-the-counter medications.
You might also be instructed to take antibiotics while you recover. This is to prevent any infections while your mouth is vulnerable to germs. Be sure to take the full course of antibiotics as instructed by your dentist.
Food to eat and foods to avoid
Staying hydrated and eating well is important for recovery, though you might not have a very good appetite directly after surgery. Ask your doctor for specific instructions on what you can eat the first few days of recovery. Think of food that will be easy to eat without much chewing, and food that won’t disrupt your blood clot or stitches.
Start with very soft food at first, such as:
- cottage cheese
- apple sauce
- mashed potatoes
When eating, avoid:
- extremely hot food that can burn the site of the surgery
- nuts or seeds that could get stuck in the hole where your wisdom teeth used to be
- drinking from a straw, or slurping too vigorously from a spoon, which can dislodge your blood clot or ruin stitches
Slowly begin eating heartier food when you feel ready.
Is it necessary to remove impacted wisdom teeth?
If your wisdom teeth are impacted but aren’t causing any problems, you probably don’t need to remove them. However, if you start developing symptoms, removing them can reduce your risk of other issues and improve your overall oral health.
What happens if you don’t remove impacted wisdom teeth?
If your impacted wisdom teeth are causing pain and other symptoms, leaving them in place can be bad for your oral health. Impacted wisdom teeth are more prone to infection and abscesses — and they can cause damage, decay and disease to healthy teeth.
Are impacted teeth more painful to remove?
While impacted wisdom teeth are generally more difficult to remove, the process isn’t necessarily more painful. Your dentist or oral surgeon will give you pain relievers to manage any post-operative (after surgery) discomfort.