When Wisdom Teeth Can’t Break Through

While wisdom tooth extraction is often considered as a preventive measure, removal of the third molars can become more urgent—for example, when wisdom teeth are partially impacted and can cause infection. In this post, we’ll answer common questions about impacted wisdom teeth and explain why it’s necessary to extract them.

What’s an impacted wisdom tooth?

An impacted tooth is one that’s trapped in your jawbone under the surface of your gums, unable to break through the bone and become a functional tooth for you to chew with. Impacted teeth have the potential to lead to future oral health problems.

Will I know if I have one?

Not all patients with impacted wisdom teeth will experience problems, but common symptoms include localized pain, bleeding and swelling. Pericoronitis, or inflammation of the gums covering the tooth, is often present with teeth that are close to the surface or partially erupted, but unable to continue moving to the surface.

How is the diagnosis made?

In 10 to 25 percent of Americans, one or more wisdom teeth never grow. So not being able to see wisdom teeth doesn’t necessarily mean there’s an impaction problem. Some impacted wisdom teeth can be diagnosed visually, particularly those that erupt part way, but then fail to completely break through the surface over time. However, most impacted wisdom teeth can be seen only on X-ray and will need to be identified by your dentist or oral surgeon.

What causes impacted wisdom teeth?

Tooth impaction is caused when a patient’s mouth is too small to fit all their teeth, a condition often brought about by a genetic predisposition. Both the length of the jawbone and tooth size come into play. When there’s not enough room for your final molars to grow in, they become lodged in place and push against the adjacent teeth.

Why does crowding matter?

In severe cases, impacted wisdom teeth can cause crowding in the mouth to the extent that teeth shift out of place, possibly even growing sideways out of the gums.

Other potential side effects of crowding include:

  • Sinus pressure, congestion and pain
  • Swollen gums, which can create pockets between teeth that are prone to cavities and bacterial growth
  • Cyst growth around impacted teeth, which can damage your jawbone.

In most cases, your oral surgeon will recommend that impacted wisdom teeth be removed promptly. Given that jawbones harden over time, extraction becomes more difficult with age.