What Is an Impacted Wisdom Tooth and What Are Its Symptoms and Treatments?

An impacted wisdom tooth is a common condition that occurs when the third molar is partially or fully trapped within the gum or jawbone. This can lead to various oral health issues, including infection, tooth decay, and gum disease. In this article, we’ll explore in detail what an impacted wisdom tooth is, its symptoms, and how it can be treated.

What Is an Impacted Wisdom Tooth?

An impacted wisdom tooth, also known as an unerupted or partially erupted third molar, is a tooth that fails to emerge fully into the mouth. Instead, it remains partially or completely trapped beneath the gum line and jawbone, even though its root has fully developed. This impaction is often due to a lack of space in the mouth. Impacted wisdom teeth are extremely common — according to the American Association of Oral and Maxillofacial Surgeons, about 90% of people have at least one impacted wisdom tooth.

Types of Impacted Wisdom Teeth

There are four main types of impacted wisdom teeth:

• Fully Impacted in the Jawbone: The tooth is completely encased in the jawbone and does not erupt at all.
• Partially Impacted: The tooth has broken through the gum line but is still partially trapped in the jaw.
• Soft Tissue Impaction: The tooth is stuck under the gum tissue but not in the bone, and this is considered less complicated.
• Erupted but Misaligned: The tooth has emerged but is tilted or misaligned in the mouth.

Positions of Impacted Wisdom Teeth

Impacted wisdom teeth can also be categorized based on their position:

• Mesial Impaction: The tooth tilts forward toward the front of the mouth.
• Vertical Impaction: The tooth is in the correct position but fails to erupt.
• Horizontal Impaction: The tooth lies flat and pushes against neighboring teeth — often causing significant pain.
• Distal Impaction: The tooth angles toward the back of the mouth.

What Causes Impacted Wisdom Teeth?

Impacted wisdom teeth generally result from a lack of space in the jaw for all teeth to emerge properly. Sometimes, the tooth grows at an incorrect angle and becomes trapped. People most at risk include those aged 17 to 25 or those with smaller jawbones. While there's no guaranteed way to prevent impaction, maintaining excellent oral hygiene can reduce potential complications.

Symptoms of an Impacted Wisdom Tooth

Common signs and symptoms include:

• Severe gum or jaw pain
• Red or swollen gums
• Inflammation or infection around the tooth
• Discomfort or difficulty chewing
• Bad breath
• Cysts or fluid-filled sacs around the tooth
• Damage to adjacent teeth
• Tooth decay
• Gum disease

In some cases, the impacted tooth can form a cavity within the jawbone, filling with fluid and creating a cyst that may damage nearby bone, nerves, or teeth. Rarely, a benign tumor may develop, requiring surgical removal.

How Is an Impacted Wisdom Tooth Diagnosed?

A dentist can diagnose an impacted wisdom tooth through a routine dental exam and X-rays. These X-rays help determine whether the tooth is impacted and assess any potential damage to nearby teeth or bone.

How Is an Impacted Wisdom Tooth Treated?

The following treatments can help relieve symptoms:

• Pain Relievers: Over-the-counter medications can help manage pain. They should be swallowed, not applied directly to the tooth.
• Saltwater Rinse: Rinsing with warm salt water several times a day can reduce inflammation and discomfort.
• Antibacterial Mouthwash: Rinses like chlorhexidine may help reduce infection.
• Dental Cleaning and Antibiotics: A dentist may clean the area and prescribe antibiotics. If symptoms recur, tooth removal may be necessary.

Surgical Removal of an Impacted Wisdom Tooth

Dentists often recommend extraction when an impacted wisdom tooth causes pain, infection, or potential damage to nearby structures.

Even when no symptoms are present, some dentists suggest preventive removal, especially if the tooth's angle may later affect other teeth or cause issues.

Wisdom tooth extraction is typically done in an outpatient setting, meaning you go home the same day. It involves:

• Local anesthesia to numb the area
• Sedation for relaxation
• General anesthesia in more complex cases to induce sleep

During surgery, the oral surgeon makes an incision in the gum, removes bone if necessary, and extracts the tooth. The site is then closed with stitches and packed with gauze. The procedure usually takes 30 to 60 minutes.

Most people return to normal activities within a few days, but full healing may take up to six weeks. Patients are advised to eat soft foods and may experience temporary difficulty opening their mouth.

Post-surgical symptoms such as pain, swelling, and minor bleeding are common and manageable with prescribed painkillers and cold compresses.

When Should an Impacted Wisdom Tooth Be Removed?

Wisdom teeth that are healthy, fully erupted, properly aligned, and easily cleanable may not require removal. However, many dental professionals recommend extraction to prevent future complications like infections or damage to other teeth.

Complications of Impacted Wisdom Teeth

Potential complications include:

• Infection
• Gum pockets or cysts
• Decay
• Crowding of nearby teeth
• Difficulty flossing or brushing
• Damage to adjacent teeth
• Abscess formation

Due to these risks, many dentists advise removal even before symptoms appear.

How Do Impacted Wisdom Teeth Affect Adjacent Teeth?

Impacted wisdom teeth can exert pressure on neighboring teeth, leading to crowding, shifting, or decay. This may necessitate orthodontic treatment to correct misalignment. Also, the second molars next to impacted teeth are more prone to infections due to the close proximity and difficulty in cleaning the area.

Symptoms of complications may include:

• Bad breath
• Earache
• Headaches
• Unpleasant taste in the mouth
• Toothache
• Gum swelling and redness
• Jaw pain or swelling
• Bleeding gums

Severe infections can lead to cellulitis in the cheek, tongue, or throat, or a condition known as pericoronitis — a gum disease triggered by bacterial buildup.

Frequently Asked Questions

How do impacted wisdom teeth affect oral health?
They can cause pain, infection, and damage to other teeth. Because they’re hard to clean, they’re more prone to decay and gum disease.

Can an impacted wisdom tooth cause headaches?
Yes. In some cases, the pressure and inflammation caused by an impacted tooth can radiate pain to the jaw, face, and head.