Wisdom teeth usually erupt between the ages of 17 to 25. It's the third molar of permanent teeth. There are altogether 4 wisdom teeth, and they erupt at the end of the upper and lower jaws. It is very common that one or more wisdom teeth are missing. For some people, their wisdom teeth can normally erupt, while for some others, their wisdom teeth may not successfully erupt and may become impacted.

A. Cause of impacted wisdom teeth

Wisdom teeth often don't have enough room to erupt because modern human beings have a shorter jawbone. This causes wisdom teeth to grow slanted, horizontally, or even to be completely buried inside the jawbone.

B. Consequences of impacted wisdom teeth

1. Pericoronitis
Usually seen in the lower jaw.

Food debris and bacteria are easily trapped in the space between the crown of the wisdom tooth and the overlying gingiva (gum), resulting in the infection of the periodontal tissues (Pericoronitis). Furthermore, the infected, swollen overlying gingiva is often bitten by the opposing tooth making it difficult to recover.

2. Dental Caries
Since it is difficult to clean the surfaces between the impacted tooth and the adjacent tooth in front, dental plaque will accumulate there and cause Dental Caries on these tooth surfaces.

3. Root resorption of the neighbouring tooth
The inflammation of the periodontal tissues caused by the dental plaque, together with the pressure of the wisdom tooth pushing on the adjacent tooth in front, may cause the root of the adjacent tooth to resorb.

4. Causes pathological changes, such as cysts.

C. Treatment

1. If wisdom tooth is completely buried inside the jawbone, nothing needs to be done given that there is no symptom. You would keep it under observation at regular dental check-up in case of any disease changes.

2. If Consider removal of impacted wisdom tooth

• Wisdom tooth problems
  • Frequent inflammation of gingivae covering the wisdom tooth causing recurrent Pericoronitis
  • Suffered from severe Pericoronitis
  • Severe caries, periodontal disease, pulpitis or periapical infections of wisdom tooth
  • Impacted wisdom tooth causing root resorption of adjacent teeth
  • Cyst around the wisdom tooth can damage the structure of jawbone. If there is a cyst formation, the cyst together with the impacted wisdom tooth must be extracted

• Prior to the following treatments

  • Extraction of mal-positioned wisdom tooth prior to orthodontic treatment
  • Radiotherapy
  • Jawbone reconstruction surgery

  The decision to remove an impacted wisdom tooth or not depends on the clinical situation, the diagnosis of dentist and the preference of patient.

3. To avoid bleeding of the wound after the surgical extraction of the wisdom tooth, you should pay attention to the following：

• On the day of surgery

  • Do not disturb the wound, rinse and brush the teeth
  • Take soft diet for a few days and use the teeth of the opposite side of the jaw for chewing
  • Do not perform heavy work or strenuous exercise
  • Do not smoke or drink alcoholic beverages

  On the day following the surgery, resume gentle toothbrushing and normal chew.

4. Reduce discomfort after surgical extraction of wisdom tooth

• Wound pain, facial swelling and difficulty on mouth opening are common after surgery

  • On the day of surgery, apply ice pack to minimize facial swelling to the affected side of your face.
  • On the day 2, apply a warm towel to the swollen area to reduce discomfort
  • Maintain good oral hygiene to prevent wound infection
  • On day 3 or 4, take soft diet. If there is pain from these wound ,take painkiller as prescribed by the dentist

  Normally, any discomfort will slowly subside in a week after surgery. Meanwhile, consult your dentist if you have any queries.