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Why impacted wisdom teeth are so dangerous

Shaena Montanari,Michael B. Ferguson   

Why impacted wisdom teeth are so dangerous
  • Impacted wisdom teeth happen when a wisdom tooth gets lodged underneath the gum line.
  • This can trigger irritation, pain, and ultimately lead to gum disease and tooth decay if not treated.
  • Impacted wisdom teeth are surgically removed by a dentist and will require anesthesia.

Impacted wisdom teeth are a serious condition that can lead to gum disease and tooth decay.

Medical term: Wisdom teeth are the third set of molars located at the very back of your mouth. If they emerge, it typically happens between the ages of 17 and 25.

Some people are born without wisdom teeth, and some people never have a problem with natural eruption because there's enough space in their jaws to accommodate them.

However, for some, there's no room left in the mouth for the wisdom tooth to emerge. In this case, the tooth becomes lodged underneath the gum's surface, causing an impacted wisdom tooth.

When this happens, it can cause gum pain and irritation at the impaction site, as well as create pockets of hard-to-reach areas where bacteria can build up and lead to dangerous infections.

The best way to deal with impacted wisdom teeth is to get your wisdom teeth removed. Here are some of the tell-tale signs of impacted wisdom teeth and when you should see a dentist.

Signs you need your wisdom teeth removed

Patel says it's always best to consult your dentist, but these are some signs you may need your wisdom teeth removed:

They are impacted. A tooth that is impacted cannot fully and correctly erupt from the gum because it is positioned against another tooth, bone, or tissue. According to the American Association of Oral and Maxillofacial surgeons, 9 out of 10 people have at least one impacted wisdom tooth.

Infection and cyst risk. A small 2015 study found that out of 52 patients, 11.5% had evidence of a cyst around an impacted wisdom tooth, and 7.7% had evidence of an infection. Infections occur with impacted wisdom teeth because they are difficult to clean and bacteria easily accumulate.

Damaging another tooth. When a wisdom tooth is impacted, it may be positioned directly against another tooth, which can cause decay and damage. "We don't want a one tooth problem to become a two tooth problem," says Patel.

A hard-to-clean tooth can lead to problems. Wisdom teeth can be difficult to clean, which can lead to gum disease and cavities. A large 2011 study found that in over 2,000 patients with an average age of 62, most had pathological issues with their wisdom teeth. Over two-thirds had visible cavities or other periodontal conditions on or around their wisdom teeth.

If the wisdom teeth are causing any of the aforementioned symptoms, a thorough evaluation, and clinical radiographic, may be done to determine if the teeth need to be removed and if it is safe to remove them without damaging the mandibular nerve.

Should I get my wisdom teeth removed?

A dentist will typically check your wisdom teeth during a routine visit to see if they need to be removed.

General advice: The American Association of Oral and Maxillofacial Surgeons policy states that not all wisdom teeth need to be removed, but they need to be evaluated and monitored.

Onika Patel, DDS, a dentist in Scottsdale, Arizona, says it is important to schedule regular checkups and cleanings because "the dentist is monitoring the eruption of wisdom teeth" every six months.

Patel says she uses a checklist to determine if a patient's wisdom teeth need to be removed. The checklist involves:

Additionally, the sinus proximity of the upper jaw to the upper wisdom teeth should be evaluated, as should the mandibular nerve in the lower jaw to determine the risk factor of wisdom teeth removal.

"I always tell patients the earlier the better [for removal] because the post-operative healing time is a little less," she says. However, wisdom teeth can be removed at any age if they are causing issues.

Considerations before having your wisdom teeth removed

Not everyone needs to get their wisdom teeth removed, but they should always be monitored by a dentist. The experts say if it is a straightforward removal, a dentist can usually take wisdom teeth out in the office. If it is a more complicated procedure, a patient will be referred to an oral surgeon.

There are some minimal risks for different types of anesthesia, such as local or conscious sedation. The type of anesthesia used will differ depending on the patient and if the teeth are extracted by a dentist or oral surgeon.

Post-surgical risks from getting your wisdom teeth removed include dry socket, which is when a blood clot at the surgical site is dislodged before the bone and tissue have healed. Patel says dry socket is "very avoidable" if a patient refrains from spitting, smoking, or sucking a straw right after surgery. There is a higher risk of "dry socket" in biological females.

She also says that bleeding at the site of the tooth removal is normal, and biting on a damp tea bag or gauze should help relieve prolonged bleeding.

For the first 24 hours after surgery, a patient should eat soft foods only. Typical recovery from wisdom teeth removal takes between three to seven days depending on how the patient feels.

Insider's takeaway

If a patient is experiencing pain, infection, tooth decay, or has impacted wisdom teeth, they will likely need to have them removed either by a dentist or oral and maxillofacial surgeon.

For those with erupted wisdom teeth that aren't causing noticeable issues, you should still get them checked frequently since early signs of periodontal disease and cavities may not necessarily come with any symptoms.

"Having routine dental care is really important not just to get your teeth cleaned, but so the dentists can monitor how those teeth are progressing," Patel says. "They can determine the best time for you to remove the wisdom teeth."

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