Wisdom teeth

What is an Impacted Wisdom Tooth?

A tooth becomes impacted due to lack of space in the dental arch and its eruption is therefore prevented by gum, bone, another tooth or all three. Lack of space occurs because our jaws have become smaller (through evolution), we do not loose teeth through decay as frequently as in the past, and our diet is such that our teeth do not wear down as much.

What are the indications for removing wisdom teeth?

Wisdom teeth generally cause problems when they erupt partially through the gum. The most common reasons for removing them are:

• Decay –saliva, bacteria and food particles can collect around an impacted wisdom tooth causing it, or the tooth next to it, to decay. It is very difficult for the dentist to remove this decay and pain and infection will usually follow.
• Gum infection (pericoronitis) –when a wisdom tooth is partially erupted, food and bacteria collect under the gum causing a local infection. This may result in bad breath, pain, swelling and trismus (inability to open the mouth). The infection can spread to involve the cheek and neck. Once the initial episode occurs, each subsequent attack may become more frequent and severe.
• Pressure pain –pain may also come from the pressure of erupting wisdom teeth against other teeth. In some cases, this pressure may cause the erosion of the teeth immediately in front of the wisdom teeth.??
• Orthodontic reasons –many younger patients have had prolonged orthodontic treatment to straighten teeth. Wisdom teeth may cause movement of teeth (particularly the front teeth) when they try to erupt and this will compromise the orthodontic result.
• Prosthetic reasons –patients who have had dentures constructed should have wisdom teeth removed. If a wisdom tooth erupts beneath a denture it may cause severe irritation, and if removed the patient may have to have another denture constructed to accommodate the changed shape of the gum.
• Cyst formation –a cyst (a fluid-filled sack) can develop from the soft tissues which originally formed the wisdom tooth. Cysts cause bone destruction, jaw expansion and displacement and damage to the adjacent teeth. The removal of the cyst and tooth is necessary to prevent further bone loss. In rare circumstances, tumours may develop within these cysts or the jaw may even fracture if the cyst or tumour grows very large.