Impacted wisdom teeth are the third molars which do not erupt properly due to obstruction caused by other teeth. This can be a significant cause of infection and inflammation which can eventually lead to pain.
Presentation
In many instances, impacted wisdom teeth do not produce signs and symptoms. In cases when they do, it is primarily attributed to the onset of gum diseases and infection that has set in. Under such circumstances, the following signs and symptoms are experienced:
- Pain in the affected area
- Tender and swollen gums
- Gums may bleed and be painful
- Development of bad breath and unpleasant taste inside the mouth
- Headache
- Swelling around the jaw area
Entire Body System
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Anemia
Certain disease conditions such as rickets, endocrine dysfunction, anemia, achondroplasia, cleidocranial dysostosis, Treacher Collins syndrome etc. have also found to be associated with impacted teeth. [sites.google.com]
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Dysostosis
Certain disease conditions such as rickets, endocrine dysfunction, anemia, achondroplasia, cleidocranial dysostosis, Treacher Collins syndrome etc. have also found to be associated with impacted teeth. [sites.google.com]
Jaw & Teeth
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Jaw Pain
Jaw Pain: Jaw pain is a common sign of impacted wisdom teeth. The pain radiates from the affected area down throughout the jaw and the jaw joint. [trapnellorthodontics.com]
Pain from an impacted wisdom tooth (or teeth) is one of the most common causes of pain, and often the culprit of jaw pain or a toothache. [acfdga.com]
However, as they progress, they can cause problems such as: Jaw pain Swelling, particularly around the gums or around the jaw Bleeding gums (though be aware that bleeding gums is also a symptom of periodontal disease ) Bad breath Difficulty opening your [thedentalexpress.com]
Clues that your wisdom teeth could be impacted include jaw pain and tenderness, redness and swelling of the gums around the tooth, bad breath, or a bad taste when you bite down on food. [crest.com]
However, when an impacted wisdom tooth becomes infected, damages other teeth or causes other dental problems, you may experience some of these signs or symptoms: Red or swollen gums Tender or bleeding gums Jaw pain Swelling around the jaw Bad breath An [drugs.com]
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Toothache
Pain from an impacted wisdom tooth (or teeth) is one of the most common causes of pain, and often the culprit of jaw pain or a toothache. [acfdga.com]
He prescribed an aggressive regimen of Amoxicillin to begin combating the pain-causing infection, and the toothache disappeared in less than a day. [dentalfearcentral.org]
An infection can lead to bad breath, earache, headache, a strange taste in the mouth, toothache, swollen gums which may be redder than usual, swollen jaw, and bleeding gums. [medicalnewstoday.com]
Tip # 3 - OTC Oral Pain Relievers Orajel Instant Pain Relief for Severe Toothache is the only over-the-counter product that has actually worked for me, including other Orajel products. [healdove.com]
This can cause toothache, earache pain, swelling and even infection, cysts and abscesses. If this is the case, then it could be necessary to have the wisdom teeth removed from your mouth. [patient.info]
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Jaw Stiffness
Symptoms of impacted wisdom teeth include: Bad breath Red gums Tender or bleeding gums Headache Jaw stiffness Unpleasant taste in mouth Difficulty opening the mouth If left untreated these symptoms can develop into worse problems such as: Damage to adjacent [familycedarrapidsdentist.com]
However, impacted wisdom teeth symptoms may include pain, swelling and bleeding around the gums, as well as headache or jaw stiffness. Some people may even experience a foul taste in the mouth while eating. [davidevansdds.com]
Possible side effects of wisdom teeth removal include: swelling, pain (very manageable with correct pain relief), jaw stiffness and light bruising. [carolineacton.com.au]
When the anesthesia wears off, there may be jaw stiffness, difficulty opening the mouth all the way, and some pain. Pain medication is often prescribed to help with any postoperative symptoms and discomfort. [medicinenet.com]
Partial eruption of the wisdom teeth allows an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. [webmd.com]
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Cheilitis
External links [ edit ] v t e Oral and maxillofacial pathology ( K00–K06, K11–K14, 520–525, 527–529 ) Lips Cheilitis Actinic Angular Plasma cell Cleft lip Congenital lip pit Eclabium Herpes labialis Macrocheilia Microcheilia Nasolabial cyst Sun poisoning [en.wikipedia.org]
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Hairy Tongue
tongue Caviar tongue Crenated tongue Cunnilingus tongue Fissured tongue Foliate papillitis Glossitis Geographic tongue Median rhomboid glossitis Transient lingual papillitis Glossoptosis Hypoglossia Lingual thyroid Macroglossia Microglossia Rhabdomyoma [en.wikipedia.org]
Workup
Impacted wisdom teeth can be clinically diagnosed in patients who have partial eruption and the teeth is visible during examination so that the angulation and depth of the impaction can be determined. Such a kind of analysis is also possible if the patients are too young for further eruption of the wisdom tooth. It has been known that, wisdom teeth continues to grow even during adulthood and significantly contribute to the development of periodontal disease [6].
When clinical diagnosis does not provide useful information about the condition, then dental X-ray examination or cone beam CT scan are used for diagnosing the condition of impacted wisdom teeth [7].
Treatment
In conditions, when the impacted wisdom teeth are causing problem, surgical removal is the best option. Complications resulting from surgical extraction of tooth are rare and therefore it is considered as the best method which is done by the socket-shield technique [8] [9].
Impacted wisdom teeth that do not cause any problems are generally considered as asymptomatic. However, there is no evidence suggesting that such teeth would not be a significant source of problem later in life too. Therefore, keeping this in mind, there have been several controversies surrounding the surgical removal of such impacted teeth. Scientists argue that, the asymptomatic impacted wisdom teeth cannot be disease free and therefore, extraction is the best method to avoid onset of future complications.
Prognosis
The prognosis of the condition gravely depends on the severity of impaction. In cases, when there is complete impaction, there is significant fear of development of cysts or neoplasms in the affected area. Such a type of phenomenon is however uncommon. In individuals with partial impaction, the chances of development of signs and symptoms usually increase with age. Studies have reported that, about 30 to 60% of individuals with impacted wisdom teeth, who were asymptomatic in the past, experienced symptoms of gums disease almost 2 to 4 years after the first examination was carried out [5].
Etiology
The major cause of wisdom teeth to get impacted is that they do not get enough space to appropriately erupt. In other conditions, the mouth is overcrowded, which does not allow enough space for the third molars to develop at a normal pace. In such situations, the third molars get trapped and thereby become impacted. Impacted wisdom tooth can either be partially impacted, wherein the crown is visible or they are completely impacted, where they do not break out from the gums [2]. There are certain pieces of evidence suggesting a genetic predisposition for development of wisdom teeth impaction [3].
Epidemiology
A large scale study carried out in New Zealand revealed that 95.6% had at least one wisdom tooth which had an eruption rate of 15% in the maxilla and 20% in the mandible. In yet another study, which was done on 5000 army recruits, showed 10,767 impacted wisdom teeth.
Pathophysiology
Wisdom teeth can either be partially or fully impacted. In both the cases, the teeth grow in the following directions:
- It may grow at an angle in the direction of second molar
- It may grow at the back of the mouth
- It my grow in a direction that forms a right angle with the other tooth; giving an appearance as if the wisdom tooth lies within the jaw bone
- Grows straight as any other teeth, but may be trapped inside the jaw bone
In individuals with partially impacted wisdom teeth, the most common reason for tooth removal are development of pericoronitis, or any other infection of the gums [4]. Statistics has revealed that, about 15% of individuals with impacted wisdom teeth suffer from cavities either on the surface of the impacted tooth or in the neighboring second molars.
Prevention
The occurrence of impacted wisdom teeth cannot be prevented. However, onset of complications can certainly be kept at bay if the condition is promptly treated by either extraction of tooth or local methods to treat gum infections. Maintaining proper dental hygiene can help in preventing the onset of gum cavities and infection [10].
Summary
Impacted wisdom teeth are also known as impacted third molars. Impacted wisdom teeth can cause damage to the teeth which are adjacent to it. In many instances however, the wisdom teeth may not cause any problems. Such teeth may be difficult to clean and therefore can be susceptible to tooth decay and onset of gum diseases [1].
Patient Information
- Definition: Impacted wisdom teeth is a condition, wherein the wisdom tooth does not fully erupt due to various factors. Such a type of condition can be a cause of great discomfort for individuals who develop pain and other associated symptoms due to tooth impaction.
- Cause: Various factors that prevent or obstruct the complete eruption of wisdom teeth give rise to impacted wisdom teeth. The major cause is when the mouth gets overcrowded with other teeth, leaving little room for the wisdom teeth to sufficiently grow.
- Symptoms: In many cases, individuals do not experience symptoms. However, when impacted wisdom teeth favors the development of cysts or gum disease, affected individuals suffer from pain, tenderness, swelling along with redness, bad breath and unpleasant taste in mouth.
- Diagnosis: Clinical examination is often enough for diagnosing impacted wisdom teeth. However, when this does not provide useful insight, then dental radiographs and core beam CT scan may also have to be employed.
- Treatment: Treatment of impacted wisdom teeth depends on whether or not the condition is causing any symptoms. In case of development of gum disease or infections, surgical extraction of the teeth is recommended. Treatment of asymptomatic impacted wisdom teeth is controversial, whether or not to be surgically removed.
References
- Mueller DT, Callanan VP. Congenital malformations of the oral cavity. Otolaryngol Clin North Am 2007; 40:141.
- Linde A, Goldberg M. Dentinogenesis. Crit Rev Oral Biol Med 1993; 4:679.
- Marks SC Jr. The basic and applied biology of tooth eruption. Connect Tissue Res 1995; 32:149.
- Delaney JE, Keels MA. Pediatric oral pathology. Soft tissue and periodontal conditions. Pediatr Clin North Am. Oct 2000;47(5):1125-47
- Ramos-Jorge J, Pordeus IA, Ramos-Jorge ML, Paiva SM. Prospective longitudinal study of signs and symptoms associated with primary tooth eruption. Pediatrics 2011; 128:471.
- Gart C, Zamanian K. Title Global trends in dental imaging: the rise of digital.
- Dölekoğlu S, Fişekçioğlu E, İlgüy M, İlgüy D. The usage of digital radiography and cone beam computed tomography among Turkish dentists. Dentomaxillofac Radiol. 2011/09;40(6):379-84).
- Hürzeler MB, Zuhr O, Schupbach P, Rebele SF, Emmanouilidis N, Fickl S. The socket-shield technique: a proof-of-principle report. J Clin Periodontol. Sep 2010;37(9):855-62.
- Shakibaie-M B. Comparison of the effectiveness of two different bone substitute materials for socket preservation after tooth extraction: a controlled clinical study. Int J Periodontics Restorative Dent. Mar 2013;33(2):223-8.
- Albandar JM, Brunelle JA, Kingman A. Destructive periodontal disease in adults 30 years of age and older in the United States, 1988-1994. J Periodontol 1999; 70:13.