Impacted Wisdom Teeth

Diagnosis

Diagnosis of impacted wisdom teeth usually begins with a dental exam. Your dentist or oral surgeon evaluates your teeth, gums and overall oral health to understand the cause of your symptoms.
Diagnostic steps often include:

• Questions about your dental symptoms and general health

• Examination of the condition of your teeth and gums

• Dental X-rays to check for impacted teeth and signs of damage to surrounding teeth or bone

Treatment

Treatment depends on whether your wisdom teeth are causing symptoms and how difficult they may be to remove. If the condition is more complex or if you have medical risks, your dentist may refer you to an oral surgeon to determine the best approach.

Managing wisdom teeth without symptoms

There is ongoing debate among dental professionals about removing wisdom teeth that are not causing symptoms, known as asymptomatic wisdom teeth.

Reasons some dental specialists recommend removing these teeth in late teens or early adulthood include:

• Symptom-free wisdom teeth may still have underlying disease

• Limited space makes impacted teeth hard to clean properly

• Serious complications occur less often in younger adults

• Removal becomes harder and riskier with age

Others recommend a more conservative approach, noting:

• There is not enough evidence that problem-free wisdom teeth will cause issues later

• Surgical risks and costs may outweigh potential benefits

• Regular monitoring can detect early signs of decay, gum disease or other problems

With conservative management, your dentist closely monitors your wisdom teeth and recommends removal only if issues arise.

Surgery to remove wisdom teeth

Impacted wisdom teeth that cause pain or dental problems are typically removed surgically. Surgery, also called extraction, may be recommended for:

• Infection or gum disease involving the wisdom teeth

• Tooth decay affecting partially erupted wisdom teeth

• Cysts or tumors associated with the teeth

• Damage to nearby teeth

• Preventing future dental problems

Wisdom tooth extraction is usually an outpatient procedure. Steps may include:

• Sedation or anesthesia
  Options include local anesthesia, sedation anesthesia or general anesthesia.

• Tooth removal
  A cut is made in the gums, and any bone blocking access to the tooth is removed. After the tooth is extracted, the surgical site is closed.

After surgery, temporary discomfort is common. You may experience bleeding, swelling or difficulty opening your mouth due to jaw muscle stiffness. Your provider will give instructions for wound care, pain relief and swelling management, including the use of pain medicines and cold compresses.

Less common complications may include:

• Dry socket, where the protective blood clot fails to form or becomes dislodged

• Infection in the tooth socket

• Damage to nearby teeth, nerves, jawbone or sinuses