The mouth can be a crowded place. By the time a person is in his or her late teens, there are typically 28 teeth in the mouth. If the wisdom teeth are able to erupt without problem, the total number of teeth a person can have is 32. Over the centuries, humans have evolved and the size of the jaw has become smaller, meaning it’s a pretty tight fit for 32 teeth in the mouth.
It’s not just the size of the jaw that has changed over the years. The foods people eat and how those foods are prepared has also changed. Cooking and eating softer foods means that people don’t need a third set of molars to help them thoroughly chew foods.
These days, if a person’s wisdom teeth do start to come in, they are likely to get impacted, or stuck, because there just isn’t enough room in the mouth for them. Impacted wisdom teeth can either be lodged in the gum or coming in at an angle, so that they are knocking into the other teeth in the mouth.
What Causes It?
The main cause of impacted wisdom teeth is simply not enough space in the mouth. An impacted tooth can either remain fully trapped beneath the gum line or partially erupt. A tooth can be impacted if it’s not at the right angle.
For example, in some cases, a wisdom tooth is impacted because it is tilted in the jaw. The tooth might be leaning forward, so that it is coming in towards the second molars, not straight up and down. It can also be leaning backwards, so that when it breaks through the gum line, it points towards the back of the mouth. It’s also possible for a wisdom tooth to be at a 90 degree angle to the gum line, so that it will never break through.
An impacted wisdom tooth can be at the correct angle, or straight up and down, but still get stuck in the jawbone. Since the size of a person’s mouth is determined at birth and there’s no way to control the angle of the erupting wisdom teeth, there’s really no way to prevent a tooth from becoming impacted.
Are There Symptoms?
Although you might often hear people talking about how they have to have their wisdom teeth removed because those teeth are impacted, in many cases, impacted teeth don’t cause any symptoms. The impaction is noticed by a dentist after taking X-rays or after examining the gums and the position of the other teeth in the mouth.
In some cases, the impacted tooth or teeth can partially break through the gums, leading to infection of either the broken gums or the tooth itself. If there is an infection, symptoms are often present, such as pain in the area, bad breath or a bad taste in the mouth, and tender or painful gums.
If the impacted tooth is affecting other teeth, by pushing on them or causing them to move out of position, symptoms can include a change in a person’s bite, pain or difficulty chewing, and swelling in the jaw.
Options for Treating Impacted Teeth
Often, oral surgery to remove the impacted wisdom teeth is the only way to treat them. There is some debate over when the teeth need to be removed. Some patients and dentists prefer to be proactive about wisdom teeth removal, and recommend taking out impacted teeth, even if they are not causing a patient any discomfort or other problems. The argument for removing asymptomatic wisdom teeth is that it’s better to take care of the issue before it becomes a problem.
Some people argue that the teeth should only be removed if they are causing an obvious problem, such as infections, pushing on the other teeth, or discomfort. If the teeth aren’t causing a big problem, the thinking is that surgery isn’t worth the risk. In that case, an oral surgeon or dentist will keep a close eye on the wisdom teeth, to make sure the impacted teeth don’t start to cause any problems.
There are more people who have had their wisdom teeth removed then who haven’t, even if the impacted teeth haven’t caused any issues. If you still have your wisdom teeth and would like to know more about your options for removing them or if you’ll be OK if they remained in your mouth, it’s a good idea to speak with an oral surgeon. Dr. Juan Arroyo, an oral and maxillofacial surgeon with more than 15 years of experience, is a member of the team at the practice of Gallardo & Lamas. He can evaluate your teeth and gums and let you know the best course of action to take. To schedule a consultation, call (305) 447-1447 today.