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A
tooth that fails to emerge or fully break through
the gum tissue is by definition "impacted". This is
a common problem associated with third molars, or
wisdom teeth, as they are the last teeth to develop
and erupt into the mouth. Other teeth can occasionally
become impacted. Although impacted teeth may occasionally
remain asymptomatic throughout a person’s life, this
is generally not the case. In most circumstances,
patients will develop one of a number of problems
related to retained impacted third molars.
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Infection
is the most common condition encountered with impacted
teeth. It may range from a localized gum infection to
an acute, extensive, life threatening infection involving
the head and neck. Localized gum infections tend to recur
intermittently when complete eruption of the tooth is
not possible. Recurrent infections (which may be subacute
and not painful for the patient) will frequently result
in gum disease on adjacent teeth which can ultimately
result in the loss of those teeth in addition to the wisdom
teeth.
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addition to this, untreatable root decay can occur in
the second molars adjacent to impacted third molars.
Tumors or cysts can also develop in conjunction with
an impacted third molar. When these lesions develop,
they can frequently cause severe bone destruction. Occasionally,
this results in the loss of adjacent teeth or segments
of jaw. |
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In
light of the clinical experience that most impacted teeth
will ultimately give rise to some type of pathology, it
is generally felt that preventive removal of impacted third
molars is indicated. Because complications are significantly
reduced when the impacted tooth has no associated pathology,
and because difficulty of removal increases with age, it
is recommend that impacted teeth be removed early; as soon
as it becomes apparent that there is insufficient space
or that they are not positioned for normal eruption. Generally,
this will occur somewhere between the ages of 16-18. At
this age, the roots of the developing tooth are usually
between one half to two thirds formed, which makes their
removal easier and the post-operative recovery smoother.
A young patient usually is also in optimal general health,
which facilitates safe anesthesia and rapid, complete healing.
In
summary, we would make the following general recommendations
regarding impacted third molars: When possible, impacted
third molars should be evaluated during the teenage years.
If
indicated, their removal will be easiest for the patient
before the roots have completely formed. When this is not
possible, elective removal of impacted teeth is generally
recommended before the patient reaches 30 years of age.
Please
feel free to contact our office to schedule an appointment
for a consultation, should you have concerns about your
wisdom teeth.
