Impacted Wisdom Teeth: What They Are, What Causes Them And When to Have Them Removed

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Impacted wisdom teeth can be a real challenge to deal with. Fortunately for you, this article contains all of the information you need to be able to spot the tell-tale symptoms of impacted wisdom teeth, and to know when to seek treatment from an oral surgeon.

As we all know, wisdom teeth are the teeth located at the very back of the mouth. There are usually four, one bracketing each side of the mouth on the top and on the bottom. The wisdom teeth erupt long after all of your other adult teeth have grown in, and while they sometimes grow in without a hitch, the jaw bone cannot always comfortably accommodate any more teeth. In situations where this is the case, the wisdom teeth become impacted, which can lead to all sorts of very serious oral and general health problems. We will be getting into much more detail about them later on in this article.

All in all, being able to identify an impacted wisdom tooth is important. You may think that impacted wisdom teeth are always easy to spot, but this simply isn’t true. Many impacted wisdom teeth can remain symptomless for weeks, months, or even longer. It can be tempting to think that they will not need to be dealt with at all if you cannot immediately spot them and if they are not causing you any pain or other obvious problems right now.

However, impacted wisdom teeth can suddenly begin to cause issues, and if this happens, you would absolutely wish that you had gotten them removed much sooner. For this reason, most dentists recommend getting any impacted wisdom teeth removed because they cause issues. Even if your wisdom teeth are only partially impacted, your dentist may still recommend that you get them removed as a preventative measure.

So, what are the signs and symptoms of an impacted wisdom tooth? And is it always necessary to get impacted wisdom teeth removed? What are the consequences if you decide to keep your wisdom tooth even if your dentist recommends getting it removed?

Keep reading to discover the answers to these – and many more – questions.

What impacted wisdom teeth are and how to spot them

Wisdom teeth usually grow in (or erupt, as it is also called) somewhere between the ages of 17 and 27. However, in some cases, the wisdom teeth may erupt either sooner or later.

When all goes well, wisdom teeth grow in without any problems. Sure, you may experience a bit of discomfort and jaw pain as your new molars grown in and align themselves with your pre-existing teeth, but this is normal and expected. Generally speaking the pain and any associated issues quickly subside once your wisdom teeth have fully come out and settled in.

However, it is not so uncommon for teeth to become impacted. This happens usually because your jaw bone and mouth are not big enough to accommodate the any more teeth. As a result, your wisdom teeth become impacted. 

Having impacted wisdom teeth simply means that your new wisdom teeth do not have enough space available to be able to grow in as they should. So what happens? They may grow in at a severe tilt or even get trapped in the jawbone on the way up – all while causing plenty of pain and tension in your jaw bone and surrounding ligaments and tissues.

Wisdom teeth may grow in wrong in any number of ways. They may come up:

  • At an angle to the next tooth (the second molar)
  • At an angle and leaning towards the back of the mouth. If this is the case, the wisdom tooth may be cutting into the soft tissues of your cheek
  • At a right angle towards the other teeth, in which case the tooth appears to be lying down within the jawbone
  • As they should, except for the fact that they also become trapped within the jaw bone

Oftentimes, impacted wisdom teeth are visible to the naked eye, but this is not always true. To help you spot an impacted wisdom tooth, here is a rundown of the most common signs and symptoms to watch out for:

  • Red, swollen, irritated gums. When a new wisdom tooth pushes up through the gums, they are likely to become irritated and inflamed. They may even bleed, and are going to be very tender and sore to touch
  • Jaw pain. Usually felt as a persistent, deep throbbing pain that refuses to subside for long. The pain usually radiates outwards from the temporomandibular joint (TMJ), the bone connecting the jaw bone and the skull
  • Swelling of the jaw. You may find that the entire area around your jaw swells up when you are dealing with an impacted wisdom tooth. The area may feel uncommonly hot and tender to touch
  • Bad breath is another unfortunate indication that you may have an impacted wisdom tooth. This is usually going to be paired with an unpleasant taste in your mouth that does not go away, even after toothbrushing
  • In some cases, you may experience problems and soreness when opening and closing your mouth. This is undoubtedly one of the most unpleasant early symptoms of impacted wisdom teeth and can interfere with your ability to chew, to yawn, and even to talk like you normally would

Although the pain and discomfort caused by impacted wisdom teeth tends to be located in the directly affected area at the very back of your mouth, behind the last molar, the pain can also radiate outwards and affect other areas of the mouth, jaw and even the skull.

If you find yourself experiencing any combination of the symptoms described here, we recommend that you contact your dentist and set up an appointment as soon as possible.

What is a partially impacted wisdom tooth?

Unlike a fully impacted wisdom tooth, a partially impacted wisdom tooth is one that has not yet fully erupted. Only part of it is going to be visible above the gum line, but it is already clear that the tooth is impacted. It may not be causing much pain or problems yet, but it is just as likely to in the future as a fully impacted wisdom tooth is.

Complications caused by impacted wisdom teeth

As already hinted at, impacted teeth can cause numerous much more serious oral and general health problems. But what are they, other than the component they all have in common, which is pain? Let us take a closer look.

Damage to surrounding teeth

One of the most common dental problems often caused by impacted wisdom teeth is damage to the other teeth already in your mouth. 

When a wisdom tooth comes up at an angle to the molar next to it, it pushes against it with a lot of force. The intense pressure may cause damage to the second molar as well as leave the entire area more vulnerable to infections. The pressure can also cause another knock-on effect, which is misaligned and crowded teeth that may end up requiring orthodontic treatment to straighten out again.

Tooth decay

Tooth decay is another risk factor associated with both fully and partially impacted wisdom teeth. 

Wisdom teeth are notoriously hard to keep clean compared to the rest of your teeth, and as a result, food particles and plaque have plenty of opportunity to build up, especially between the partially erupted tooth and the gums. As a result, tooth decay may set in.

Cysts and abscesses

When a wisdom tooth develops, it happens within a sack lodged within the jawbone. If the wisdom tooth becomes impacted, the sack might fill with fluid, which in turn forms a cyst or abscesses. 

Wisdom teeth cysts are no joke as they are capable of causing plenty of damage to the tooth, jaw bone and nerves. In rare cases, the cyst may develop into a tumor. 

Gum disease

Although usually a result of poor oral hygiene, gum disease is also a very common complication of fully and partially impacted wisdom teeth.

Gum disease typically manifests as red, sore, swollen and tender gums. In some cases, the gums may also start bleeding spontaneously or in connection with tooth brushing.

Throat infection

Sometimes the abscesses caused by impacted wisdom teeth can cause bacteria to spread to the rest of your mouth and throat, which in turn can cause throat infections. In rare cases, these throat infections can be lethal.

Surgical removal versus retention

A very important question remains to be answered. Knowing all of the risks that having impacted wisdom teeth carry, should you always get an impacted wisdom tooth removed, or is it sometimes enough to just have it monitored by your dentist to make sure that no problems develop?

First of all, it is impossible to prevent wisdom teeth from becoming impacted. Whether or not your wisdom teeth become impacted is decided by genetics, the size of your jaw bone and other factors beyond your control. What you can do instead is to attend regular checkups with your dentist, and keep an eye out for potentially impacted wisdom teeth.

Dentists do not recommend removing healthy wisdom teeth that grow in without any complications. Wisdom teeth are not inherently bad, but when they become impacted, they are always a liability. Even if your impacted wisdom teeth are not causing you much pain or grief at this particular moment in time, there is a very high likelihood that they will at some point in the future.

In most cases, it is best to get impacted wisdom teeth removed. Consider it a preventative measure, a way of ensuring that you will not ever have to deal with any of the unpleasant complications they can bring with them.

Impacted wisdom teeth FAQ

Is it necessary to remove impacted wisdom teeth?

Yes. Although we are not talking about an emergency, impacted wisdom teeth should be removed by an oral surgeon as soon as possible.

Wisdom teeth that are impacted are not only painful, they can cause all manner of knock-on effects, including gum disease, throat infections and throbbing pain. They can also affect the adjacent teeth, tissues and even your jaw bone negatively.

What does it feel like to have an impacted wisdom tooth?

Pain is the most common warning sign that one or more of your wisdom teeth are impacted. 

Since wisdom teeth erupt at the very back of the mouth, they can cause a lot of discomfort and jaw pain, particularly while chewing or yawning.
Another tell-tale sign of impacted wisdom teeth is inflamed, irritated, swollen or bleeding gums surrounding the teeth that are impacted.

What happens if impacted wisdom tooth is not removed?

Impacted wisdom teeth that are left untreated can and most likely will lead to any number of escalated oral and general health problems. These can range in severity from inflamed gums to dangerous neck infections. 

Some of the most common problems that can happen if impacted wisdom teeth are left in the mouth is that they can shift parallel to the jaw line or even backwards in the mouth, to the extent that it can make opening and closing your mouth properly very difficult. Not only is this highly impractical, it can also be painful.
Impacted wisdom teeth may also push against the surrounding teeth, causing your teeth to become crowded and misaligned.

Another common issue that can happen when wisdom teeth are impacted is that they can irritate the surrounding gum tissues, causing inflammation, pain and gum disease. 

In extreme cases, impacted wisdom teeth can lead to tooth loss and bone erosion, either of which may be felt like a constant throbbing pain, and at least one of which can be potentially fatal.

In other words, you do not want to leave impacted wisdom teeth in your mouth any longer than absolutely necessary. 

Are impacted wisdom teeth more painful to remove?

Unfortunately, impacted wisdom teeth are harder to remove, which means that they are also more likely to hurt or cause dental complications.

The reason for this is that impacted wisdom teeth are likely to affect and sometimes damage gums, ligaments, teeth and bones in the affected area. Removing them without irritating or affecting the surrounding tissues and bones further requires a highly trained dental surgeon called a maxillofacial surgeon.

Should I remove impacted wisdom teeth if they do not hurt?

Yes, even if your impacted wisdom teeth are not currently causing you any pain or other problems that you are aware of, you should still get them removed as a preventative measure. Even partially impacted wisdom teeth should be removed in the vast majority of cases, to protect yourself against all of the many serious oral and general health problems that can arise if you choose not to go through with surgical removal.

The reason why you should always get impacted wisdom teeth removed, even if they are not causing you any trouble right now, is that they are likely to cause dental complications and negative outcomes in the future, ranging from gingivitis to life threatening infections. When it comes to your oral and general health, taking unnecessary chances is really not worth it – even if you don’t think your impacted teeth are a problem right now.

How soon does an impacted wisdom tooth need to be removed?

According to the American Dental Association, impacted wisdom teeth should be removed as soon as possible, particularly if they are causing either pain, repeated inflammation and infection of the soft gum tissue around the lower last tooth, or the formation of cysts, which are fluid-filled sacs.

Whenever you are facing a dental problem, it is always better to get it dealt with sooner rather than later. There is never a convenient time to go to the dentist, and many people may feel a sense of resistance against booking or showing up for their appointment. Oral and maxillofacial surgery can seem daunting, not to mention costly and time-consuming. However, an impacted wisdom tooth that is not removed can lead to much more serious dental issues and general health issues.

Putting off seeing your dentist and getting your impacted wisdom teeth removed is not worth it.

Takeaway

Impacted wisdom teeth are no joke. Often painful and nearly as often dangerous to both your oral and overall health, it is better to have impacted wisdom teeth removed, and hopefully before they have the chance to cause you too much trouble.

In all cases, you should listen to your dentist’s instructions and advice. It is possible that your dentist will recommend monitoring how your wisdom teeth develop, if they have not fully erupted yet. But in many cases, your dentist is likely to recommend surgical removal of your impacted wisdom teeth – our recommendation is that you say yes to the procedure.

Dr Febin Mary George - Editor

With more than 10 years as a dental surgeon, Dr Febin Mary George is passionate about educating consumers around the world to help look after their teeth.

She completed her Bachelor of Surgery at the Century Institute of Dental Science and Research Centre in 2010.

Alongside editing the International Journal of Dental Clinics she has also written for major publications including Thrive Global.