Wisdom teeth, also known as third molars, are the final set of molars to emerge in the mouth, typically making their appearance in late adolescence or early adulthood, between the ages of 17 and 25. These teeth often pose challenges due to limited space in the jaw, which can lead to them growing in an abnormal position. When a wisdom tooth grows “sideways,” it means it is impacted, failing to fully erupt into the mouth and instead growing at an angle or horizontally.
Understanding a Sideways Wisdom Tooth
A sideways wisdom tooth refers to an impacted tooth that has not fully emerged through the gum line. It grows at an angle, horizontally, or is partially visible but misaligned. This condition, known as impaction, occurs when the tooth is prevented from erupting due to a physical barrier, such as other teeth, or when it is angled away from a vertical position.
Insufficient jaw space is a primary reason for this misalignment, as modern human jaws often lack room for all 32 adult teeth. Genetics can also play a role in jaw size and the potential for tooth eruption.
Types of impaction include:
Mesial (angled towards the front)
Distal (angled towards the back)
Vertical (in the correct position but trapped)
Horizontal (lying completely on its side)
Common Issues Caused by Sideways Wisdom Teeth
Localized jaw pain is a frequent issue, sometimes radiating to the ear or head. This pain often results from the impacted tooth pushing against neighboring teeth or stressing the jaw joint.
Pericoronitis, an inflammation and infection of the gum tissue around a partially erupted wisdom tooth, is a common complication. It can cause swelling, tenderness, difficulty opening the mouth, and an unpleasant taste or bad breath due to trapped food and bacteria. The difficult-to-clean position of impacted wisdom teeth also increases the risk of dental decay in the wisdom tooth itself or the adjacent second molar.
Pressure from a sideways wisdom tooth can damage adjacent teeth, potentially causing resorption or shifting of neighboring teeth. In some instances, a fluid-filled sac, known as a dentigerous cyst, can form around the crown of the impacted tooth within the jawbone. These cysts can damage bone, teeth, and nerves, although they are noncancerous.
Identifying and Addressing the Problem
Diagnosis involves a dental examination and X-rays, particularly a panoramic X-ray. This imaging provides a comprehensive view of the wisdom teeth’s position relative to other teeth and the jawbone, allowing determination of impaction and exact orientation.
Seeking dental care is appropriate if a person experiences persistent pain, swelling, or difficulty chewing. Extraction is the most common treatment for symptomatic or problematic sideways wisdom teeth. This procedure prevents or resolves issues like pain, infection, and damage to other teeth. Removal is recommended for impacted teeth causing issues or posing a risk for future problems.
What to Expect with Removal and Healing
Before removal, patients receive pre-operative instructions, including fasting and arranging transportation home. Anesthesia options range from local (numbing the area while awake) to sedation (inducing a sleepy state) or general anesthesia (fully unconscious).
The oral surgeon will make an incision in the gum tissue, and if necessary, remove some bone that is covering the tooth. The tooth may be removed in one piece or, if complex, sectioned into smaller pieces for easier extraction. The area is then cleaned, and stitches, often dissolvable, may be placed to help the site heal.
After the procedure, pain management with prescribed or over-the-counter medication is common, especially within the first few days. Swelling can be reduced by applying ice packs to the cheek for the first 24-48 hours. A soft diet is recommended for several days.
Gentle oral hygiene, such as warm salt water rinses, can begin 24 hours after surgery, avoiding the extraction site directly. Strenuous activity should be restricted for a few days to prevent increased bleeding and swelling.
Temporary swelling, bruising, and minor discomfort are common post-operative experiences. Full recovery typically takes one to two weeks.
Potential complications include dry socket, a painful condition where the blood clot dislodges, or temporary numbness. Patients should contact their dentist if they experience severe pain, worsening swelling, or signs of infection. Follow-up appointments are important to ensure proper healing.