An impacted wisdom tooth is one that cannot come through the gum properly because there isn’t enough room or it’s growing at the wrong angle. It may stay trapped in the jawbone or break through only partly. Impacted wisdom teeth often cause pain, swelling and repeated infections, and many need to be surgically removed. Others cause no problems and can simply be monitored.
Why do wisdom teeth become impacted?
Wisdom teeth (third molars) usually arrive between the ages of 17 and 25, long after the other adult teeth. By then, many jaws simply don’t have space left. The tooth gets blocked by the tooth in front of it, by bone or by gum tissue.
Types of impacted wisdom teeth
| Type | Position | How common |
|---|---|---|
| Mesioangular | Tilted forward towards the tooth in front | Most common |
| Vertical | Upright but blocked from coming through | Common |
| Horizontal | Lying on its side, pushing into the next tooth | Less common, often painful |
| Distoangular | Tilted backwards towards the back of the jaw | Least common |
Impactions are also described by depth: soft tissue (covered only by gum), partial bony (partly in bone) or full bony (completely encased in bone).
Symptoms of an impacted wisdom tooth
- Pain or tenderness at the back of the jaw
- Red, swollen or bleeding gums behind the last molar
- A bad taste or bad breath that keeps coming back
- Difficulty or pain opening your mouth
- Swelling of the jaw or cheek
- Headaches or earache on the same side
Some impacted teeth cause no symptoms at all and are only found on an X-ray.
Problems impacted wisdom teeth can cause
- Pericoronitis: infection of the gum flap over a partly erupted tooth, which can flare up again and again
- Decay in the wisdom tooth or the molar in front, which is hard to clean
- Damage to the neighbouring tooth’s root
- Gum disease around the back teeth
- Cysts, which occasionally form around the tooth and damage bone
Do impacted wisdom teeth always need removing?
No. We recommend removal when an impacted tooth is causing pain, infection, decay or damage to neighbouring teeth, or is likely to. If it’s healthy and causing no harm, we may monitor it with regular check-ups and X-rays instead.
How impacted wisdom teeth are removed
- Assessment and X-ray. A panoramic X-ray shows the tooth’s position. A 3D scan may be used if the roots sit close to the jaw nerve.
- Anaesthetic and sedation. The area is numbed with local anaesthetic. Sedation or a general anaesthetic can be used so you’re relaxed or fully asleep.
- Removal. A small opening is made in the gum, and the tooth may be divided into sections to remove it with less bone removal.
- Stitches. The gum is closed, usually with dissolving stitches.
Most people recover within one to two weeks. Younger patients often heal faster, which is one reason early removal is sometimes recommended.
In-house sedation and medical aid at Melrose Advanced Dentistry
We provide in-house sedation for wisdom tooth removal and all other surgical procedures. More complex impactions can be removed under general anaesthetic, and we accept medical aid for all surgical procedures done under general anaesthetic. We also claim directly from your medical aid for all surgical procedures, so you don’t have to submit the claim yourself. Procedures completed in the dental office range from R2000 to R3000 including sedation.
Frequently asked questions
Is impacted wisdom tooth removal painful? You won’t feel pain during the procedure. Afterwards, expect soreness and swelling for a few days, managed with pain relief.
Can I have all four wisdom teeth removed at once? Often, yes, especially under sedation or general anaesthetic. It means one recovery period instead of several.
Are there risks? Complications are uncommon. They include dry socket, infection and, rarely, temporary numbness of the lip or tongue if roots are near a nerve. We assess this before surgery.
What age should impacted wisdom teeth be removed? If removal is needed, the late teens to mid-twenties is ideal, when roots are less developed and healing is faster.
Wisdom tooth pain? Book an assessment at Melrose Advanced Dentistry in Melrose, Johannesburg: call 072 200 1774 or visit advanced-dentistry.co.za.