Wisdom teeth problems are very common. For most people, the jaw bone is actually not big enough to fit all 32 permanent teeth. Since wisdom teeth are the last to develop, they are often crowded out of their proper eruption position or blocked by the overlying bone or gums. When a tooth fails to erupt properly, it is said to be impacted.
Impacted wisdom teeth.
When the wisdom teeth begin to erupt, usually in the late teens or early 20s, a recurrent cycle of infection of the gums can occur. This causes pain around the tooth, which sometimes spreads to the neck or side of the face.
(a) (b) (c)
Complications such as infection (fig. a) , damage to adjacent teeth (fig. b) and the formation of cysts (fig. c) may arise from impacted teeth.
If left in place, impacted wisdom teeth can cause chronic infections that damage adjacent teeth or cause severe recession of the gums and bone. If a wisdom tooth erupts with no opposing tooth, it may cause accidental cheek biting or may hyper-erupt, causing disruption of the occlusion or bite of the other teeth. More serious problems occur if the tissue surrounding an impacted tooth enlarges to form a cyst or tumor.
Left: An impacted wisdom tooth has caused the loss of the adjacent tooth, and hyper-eruption of an upper wisdom tooth. Right: A cyst surrounding an impacted wisdom tooth.
Wisdom teeth are also associated with crowding of lower incisor teeth in late teens and early twenties. If left long enough, it may require orthodontic retreatment.
Lower incisor crowding associated with impacted wisdom teeth.
Scientific studies show that wisdom teeth that do erupt are as prone to disease as those that remain impacted. Oral hygiene is difficult in the far reaches of the mouth, and wisdom teeth are often quickly attacked by the bacteria that cause decay or gum infection. If they were not taken out during the teen years, a high proportion of wisdom teeth will eventually need to be removed in later years.