Wisdom teeth, also known as third molars, are the last set of adult teeth to emerge, typically appearing in the late teens or early twenties. While some wisdom teeth erupt without issues, it is common for them to grow at an angle or become trapped beneath the gums, a condition often referred to as growing “sideways.” This sideways growth is a frequent dental concern that can lead to various problems if left unaddressed.
Understanding Impacted Wisdom Teeth
When a wisdom tooth grows sideways or fails to erupt properly, it is medically termed an “impacted” wisdom tooth. Impaction occurs when there is insufficient space in the jaw for the tooth to fully emerge into the mouth. The tooth can be partially or fully trapped beneath the gum tissue or jawbone.
Impacted wisdom teeth are classified by their orientation and depth.
Horizontal impaction: The tooth lies completely on its side, often pressing against the adjacent molar.
Mesial impaction: The tooth angles forward toward the front of the mouth, which is the most common type.
Distal impaction: The tooth angles toward the back of the mouth.
Vertical impaction: The tooth is in an upright position but remains trapped beneath the gums or bone.
Impaction can also be classified by the tissue covering the tooth. It may be soft tissue, where the tooth is covered only by gum, or bony, where it is encased within the jawbone.
Why Wisdom Teeth Grow Sideways
The primary reason wisdom teeth grow sideways often relates to the evolution of the human jaw. Over generations, human jaw size has decreased, frequently leaving inadequate space for these late-erupting molars to emerge correctly. This reduction in jaw size means that by the time wisdom teeth attempt to erupt, there may not be enough room for them in alignment with other teeth.
Genetics also play a role in determining jaw and tooth size, influencing the likelihood of impaction. If a person inherits a smaller jaw structure, the probability of impaction increases. The position of other teeth can further contribute to impaction by blocking the wisdom tooth’s path of eruption.
Symptoms and Complications of Sideways Growth
Impacted wisdom teeth can cause a range of symptoms, though some may remain asymptomatic. Common signs include pain in the jaw, ear, or head, swelling of the gums or jaw, and tenderness in the affected area. Individuals may also experience difficulty opening their mouth fully, bad breath, or an unpleasant taste.
Beyond these symptoms, sideways growth can lead to several complications if not addressed. The pressure from an impacted wisdom tooth can damage adjacent teeth, potentially causing root resorption or decay. Gum disease, specifically pericoronitis, is common when a partially erupted wisdom tooth creates a flap of gum tissue that traps food and bacteria, leading to inflammation and infection. In some cases, fluid-filled sacs called cysts can form around the impacted tooth, which can damage the jawbone, surrounding teeth, and nerves. While rare, tumors can also develop from these sacs.
Diagnosis and Treatment
Diagnosing sideways-growing wisdom teeth primarily involves a dental examination and X-rays. Panoramic X-rays are particularly useful as they provide a comprehensive view of the entire jaw, allowing the dentist to visualize the wisdom teeth’s position and identify impaction. This imaging helps determine the angle and depth of the tooth, guiding treatment decisions.
Treatment approaches vary depending on the tooth’s condition and the presence of symptoms. For asymptomatic impacted teeth that are not causing problems, regular monitoring might be recommended. However, extraction is often necessary if the tooth causes pain, infection, or poses a risk of damage to other teeth. The extraction process can range from a simple procedure for less complex cases to a more involved surgical removal, especially if the tooth is deeply impacted or requires bone removal. A dental professional can assess the specific situation and provide personalized advice on the most appropriate course of action.