What Is an Impacted Wisdom Tooth? When Should It Be Extracted?

Wisdom teeth are the last molars that erupt at the very back of the jaw and usually begin to emerge between the ages of 17 and 25. In some individuals these teeth may erupt without any problems, while in many others there is insufficient space in the jaw for the tooth to fully emerge, and it remains embedded beneath the bone or gum tissue. This condition is referred to as an "impacted wisdom tooth." Impacted teeth may over time cause various problems such as pain, infection, decay, and damage to adjacent teeth.

What Is a Wisdom Tooth?

Wisdom teeth are also known as third molars. Most individuals have a total of four — two upper and two lower. However, in some people these teeth may not develop at all, or only some of them may erupt.

Impacted wisdom teeth can be found in various positions. Some teeth may remain entirely within the bone, while others may partially emerge through the gum tissue. In some cases the tooth may be oriented horizontally, exerting pressure against the adjacent tooth, while in other cases it may remain impacted at an angle.

Why Can an Impacted Wisdom Tooth Cause Problems?

Impacted teeth most commonly cause pain and a sensation of pressure. Pressure on the surrounding tissues may develop particularly while the tooth is attempting to erupt. This pain can sometimes radiate to the ear, jaw, or temple region.

In partially erupted impacted teeth, bacterial accumulation beneath the gum tissue is more likely. This can lead to a gum infection known as pericoronitis. Swelling, redness, difficulty opening the mouth, bad breath, and occasionally fever may be observed.

Horizontally or angularly positioned impacted teeth may exert pressure on the adjacent healthy tooth, leading to decay or root damage. In some cases, the follicular sac surrounding the impacted tooth may develop into a cyst over time. Untreated cysts can progress to resorption of the jawbone.

Does an Impacted Wisdom Tooth Always Need to Be Extracted?

No. Not every impacted wisdom tooth requires extraction. If the tooth is entirely asymptomatic, is not causing damage to the surrounding tissues, and can be monitored regularly, extraction may not be necessary.

However, extraction may be recommended in the following situations:

  • Recurrent infection is present
  • Pain and swelling are present
  • Damage to the adjacent tooth is occurring
  • Decay has developed
  • Cyst formation is present
  • Space is required for orthodontic treatment
  • Adequate cleaning is not possible

How Is an Impacted Wisdom Tooth Extracted?

For partially erupted teeth, procedures similar to a standard tooth extraction may be performed. For teeth that are fully impacted or in a difficult position, however, surgical extraction is required.

Local anaesthesia is administered during the surgical procedure so that the patient does not feel pain. The gum tissue is incised to access the tooth. Where necessary, the tooth may be sectioned into smaller pieces for removal, and the area is sutured closed at the end of the procedure.

The duration of the extraction may vary depending on the position of the tooth and is generally completed within 20–60 minutes.

What Should Be Considered After Extraction?

Following the extraction of an impacted tooth, certain guidelines should be observed to support a healthy healing process.

The dressing should be used as directed for the first 24 hours. Hot, hard, and spicy foods should be avoided on the same day. The use of tobacco and alcohol may delay healing. The use of a straw is not recommended, as it can dislodge the blood clot.

Applying ice externally may help reduce any swelling that develops. Taking the medications prescribed by the clinician as directed supports the healing process.

Frequently Asked Questions

Is the extraction of an impacted wisdom tooth painful?

Since the procedure is performed under local anaesthesia, no pain is felt during the extraction. Mild pain and swelling afterwards are normal.

How long does an impacted tooth extraction take?

Depending on the position of the tooth, the procedure generally takes between 20 and 60 minutes.

Can more than one wisdom tooth be extracted at the same time?

In some cases, the upper and lower teeth on the same side may be extracted in a single session. However, separate sessions may sometimes be preferred to allow for a more comfortable recovery.

What happens if an impacted tooth is not extracted?

Problematic impacted teeth may over time lead to serious complications such as infection, decay, bone loss, and damage to adjacent teeth.

Conclusion

Impacted wisdom teeth can cause problems such as pain, infection, and tooth damage in many individuals. Regular dental check-ups allow the condition of these teeth to be assessed at an early stage, and appropriate treatment can be planned when necessary. It is important to seek a specialist evaluation without delay, particularly if symptoms such as pain, swelling, or difficulty opening the mouth are present.