Wisdom teeth, also known as third molars, are the last set of teeth to emerge, typically during the late teenage years or early twenties. While some individuals experience no issues with their wisdom teeth, many encounter problems due to insufficient space in the jaw. When these teeth are unable to erupt properly, they become impacted, leading to various concerns. Understanding the signs that indicate an emergency with an impacted wisdom tooth is important for timely intervention.
Understanding Impacted Wisdom Teeth
An impacted wisdom tooth occurs when the third molar is prevented from fully emerging through the gum line or jawbone. This often happens because there is not enough room in the jaw to accommodate the tooth, or the tooth grows at an incorrect angle. Impaction can involve the tooth being completely encased within the jawbone (full bony impaction), partially visible through the gum (partial bony impaction), or emerged from the jawbone but not fully through the gums (soft tissue impaction).
Wisdom teeth can also be classified by their angle of growth:
Mesial impaction: The tooth angles forward toward the front of the mouth.
Distal impaction: The tooth angles toward the back of the mouth.
Vertical impaction: The tooth is in the correct upright position but remains trapped.
Horizontal impaction: The tooth lies completely on its side, often pushing against the adjacent molar.
These varying orientations can contribute to diverse symptoms and potential complications.
Recognizing Emergency Signs
Certain symptoms associated with an impacted wisdom tooth signal a dental emergency, requiring immediate professional attention. Severe, throbbing pain that is unmanageable with over-the-counter pain relievers indicates a serious issue. Significant swelling in the jaw, face, or neck suggests a spreading infection and warrants urgent evaluation. This swelling can sometimes make it difficult to open the mouth fully, a condition known as trismus, or cause trouble swallowing.
Fever, chills, or a general feeling of illness alongside oral symptoms points to a systemic infection. Pus or a foul discharge from the gum around the affected tooth indicates infection. Sudden, sharp pain radiating to the ear or head can also signal a worsening problem. These acute symptoms suggest a rapidly progressing condition that requires prompt attention to prevent serious health complications.
Non-Urgent Symptoms and When to Seek Care
While some symptoms demand immediate care, others are less urgent but still require a dental visit. Mild to moderate pain or discomfort around the wisdom tooth manageable with typical pain relief is a common, non-emergency symptom. Slight swelling or tenderness around the gum flap, known as an operculum, covering a partially erupted wisdom tooth indicates localized inflammation called pericoronitis. This condition can cause pain and mild discomfort, but often does not present with the severe signs of a widespread infection.
Bad breath or an unpleasant taste in the mouth can result from food particles and bacteria becoming trapped under this gum flap, making cleaning difficult. Occasional jaw stiffness or soreness, especially when opening or closing the mouth, is another common symptom not typically an emergency unless accompanied by severe pain or limited mobility. Although these symptoms are not emergencies, they indicate the impacted tooth is causing problems and a dental assessment is necessary to prevent further issues.
Why Prompt Attention Matters
Ignoring an impacted wisdom tooth, even one with non-urgent symptoms, can lead to a progression of oral health problems. Pericoronitis, inflammation of the gum tissue around a partially erupted tooth, can become chronic or recur, serving as a breeding ground for bacteria. Over time, pressure from an impacted wisdom tooth can damage adjacent teeth, leading to decay in the neighboring molar or even root resorption. This pressure can also contribute to the crowding or misalignment of other teeth.
Fluid-filled sacs called cysts can form around impacted wisdom teeth within the jawbone, expanding and damaging the jawbone, nerves, and surrounding teeth. In rare instances, these sacs can lead to non-cancerous tumors. An untreated infection around an impacted wisdom tooth can spread to other parts of the mouth (e.g., sinuses or jawbone) and, in severe cases, into the bloodstream, posing a risk to overall health. Regular dental evaluations are important to monitor wisdom teeth and prevent serious complications.