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By Mayo Clinic staff
Problems with impacted wisdom teeth
Wisdom teeth, or third molars, are the last permanent teeth to appear (erupt) in the mouth. These teeth usually appear between the ages of 17 and 25. Some people never develop wisdom teeth. For others, wisdom teeth erupt normally — just as their other molars did — and cause no problems.
Many people, however, develop impacted wisdom teeth — teeth that don't have enough room to erupt into the mouth or grow normally. Impacted wisdom teeth may erupt only partially or not at all.
An impacted wisdom tooth may:
- Grow at an angle toward the next tooth (second molar)
- Grow at an angle toward the back of the mouth
- Grow at a right angle to the other teeth, as if the wisdom tooth is "lying down" within the jawbone
- Grow straight up or down like other teeth but stay trapped within the jawbone
You'll likely need your impacted wisdom tooth pulled if it results in problems such as:
- Pain
- Infection
- Damage to an adjacent tooth
- Development of a fluid-filled sac (cyst) around the wisdom tooth
- Damage to surrounding bone
- Complications with orthodontic treatments to straighten other teeth
Preventing future dental problems
Dental specialists disagree about the value of extracting impacted wisdom teeth that aren't causing problems (asymptomatic).
Here's the rationale for preventive treatment:
- It's difficult to predict future problems with impacted wisdom teeth.
- Symptom-free wisdom teeth could still harbor disease.
- Having your wisdom teeth makes you vulnerable to gum disease and tooth cavities.
- Removing impacted teeth lowers the risk of potential problems.
- Serious complications rarely happen in younger adults.
- Older adults may experience difficulty with surgery and complications after surgery.
Other specialists argue that there isn't enough evidence to suggest that impacted wisdom teeth not causing problems in young adults will later cause problems. Therefore, they suggest that the expense and risks of the procedure don't justify the expected benefit.
- Wisdom teeth. American Association of Oral and Maxillofacial Surgeons. http://www.aaoms.org/wisdom_teeth.php. Accessed Feb. 29, 2012.
- Marciani RD. Third molar removal: An overview of indications, imaging, evaluation, and assessment of risk. Oral and Maxillofacial Surgery Clinics of North America. 2007;19:1.
- Bagheri SC, et al. Extraction versus nonextraction management of third molars. Oral and Maxillofacial Surgery Clinics of North America. 2007;19:15.
- Haug RH, et al. Evidenced-based decision making: The third molar. Dental Clinics of North America. 2009;53:77.
- Tintinalli JE, et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, N.Y.: The McGraw-Hill Companies, Inc.; 2011. http://www.accessmedicine.com/content.aspx?aID=6388295. Accessed Feb. 29, 2012.
- Kandasamy S, et al. The wisdom behind third molar extractions. Australian Dental Journal. 2009;54:284.
- Postextraction problems. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/dental_disorders/dental_emergencies/postextraction_problems.html. Accessed Feb. 29, 2012.
- Farish SE, et al. General technique of third molar removal. Oral and Maxillofacial Surgery Clinics of North America. 2007;19:23.
- Carr AB (expert opinion). Mayo Clinic, Rochester, Minn. March 9, 2012.
- Mettes DTG, et al. Interventions for treating asymptomatic wisdom teeth in adolescents and adults. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003879.pub2/abstract. Accessed March 22, 2012.
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