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Impacted Wisdom Tooth


Wisdom teeth are the last teeth to erupt in your oral cavity. They belong to the set of teeth called molars. The normal age of eruption of these teeth ranges from 17 to 25, although it can vary in different individuals. In many people, these teeth develop to completion, but they are unable to erupt into the oral cavity. They remain impacted inside the jaw bone and may cause pain and other complications. Such teeth need to be removed surgically to provide relief. 


Wisdom teeth are placed at the far end of your oral cavity. Two are present at each end of maxillary teeth and two at each end of mandibular teeth. Because these teeth erupt at a late stage of life, it is possible that the jaw may not have enough space to accommodate these teeth. It has been noticed that people with smaller or underdeveloped jaw bones tend to have impacted wisdom teeth in their oral cavity.

In some cases, the crowding of the rest of the teeth can also affect the eruption of wisdom teeth. It is possible to have either one, two or all four of your wisdom teeth impacted in the jawbones. In certain cases, these teeth may erupt partially and put pressure on the adjacent second molar. This may cause issues in the second molar as well. 


Based on the angle of impaction in the jaw bone, wisdom tooth impaction can fall into the following four categories:

  • Mesioangular impaction
  • Distoangular impaction
  • Vertical impaction
  • Horizontal impaction

Risk Factors And Epidemiology

There is no way to determine whether a wisdom tooth will erupt normally or remain impacted in the jaw bone. Some research has shown that wisdom teeth' impaction may be associated with genetic factors. Family history may increase the probability of impaction, but it may not be the case in many individuals. Those with developmental disorders, underdeveloped jawbones, or malocclusion may also have an increased risk of wisdom teeth impaction.

About 25% of the global population present with the problem of impacted wisdom teeth. In this case, the majority of the patients are young individuals. The incidence of impacted wisdom teeth among older adults was found to be low because most of the individuals get it extracted at an early stage. 

Signs And Symptoms

Wisdom tooth impaction may remain asymptomatic for a long period. If it becomes symptomatic, the early sign is pain at the far end of the jaw region. It can occur in either one or both of the jawbones. Pain and discomfort can also cause difficulty in biting and swallowing food. The pain can vary from a dull ache to a sharp, throbbing sensation. Severe pain can also cause sleep disturbance. It becomes difficult to open your mouth to its full extent in certain cases. If the tooth is partially impacted, it can also lead to food impaction and gum issues. The gum tissue around the tooth becomes inflamed and swollen. Gum bleeding may also be present. In severe cases, swelling can extend to the face and neck region.


The diagnostic procedure begins with a history, followed by a clinical examination of the affected tooth/teeth. Your doctor will ask questions about your symptoms' onset, duration, and severity. Clinical examination is done using a dental mirror and probe. The extent of gingival involvement is also noticed. The conformational diagnosis of wisdom teeth is made based on dental x-rays. If you have more than one impacted tooth, an Orthopantomogram (OPG) is done to determine the extent of the impaction. 

Differential Diagnosis

Other issues that may resemble the symptoms of impacted wisdom teeth include local gingival swelling, caries or a dental abscess, temporomandibular disorder, etc. Conformational tests should be done to differentiate impacted teeth from other dental conditions. 


Treatment of impacted wisdom tooth/teeth depends on the severity of your symptoms. If you have an asymptomatic impaction of a wisdom tooth, it is better to leave it unless it causes any problem. This decision of treatment of asymptomatic impactions is taken by your dentist. If the impacted tooth is causing pain, gum swelling, and other issues, the best treatment option is the extraction of the said tooth. Wisdom teeth are considered accessory teeth; therefore, their removal does not cause any significant changes in the functioning of your oral cavity.

The treatment process involves an outpatient surgery. In the majority of the cases, a local anesthetic is injected on the side where the tooth is impacted. After complete anesthesia is achieved, an incision is placed to cut through the soft tissues layer. The impacted tooth is exposed to a certain extent and removed using extraction forceps. Once the tooth is completely extracted, removable sutures are placed to seal the soft tissues. 

Medications, including analgesics such as naproxen, ibuprofen, etc., and antibiotics such as amoxicillin, metronidazole, etc., are prescribed after extraction to limit the risk of post-operative complications. 


After surgical extraction, it can take 4 to 6 weeks for complete bone and soft tissue healing. Some people may develop post-operative complications such as dry socket, swelling, incomplete healing, etc., which need to be treated immediately by your dentist. 


It is difficult to predict the occurrence of impacted wisdom teeth; hence it is impossible to prevent it. However, if you visit your dentist regularly, they can tell you about the development of your teeth and the risk of impacted teeth. Early diagnosis and treatment can also save your other teeth from future complications. 


Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on April 30th, 2023.