Impacted tooth are tooth that have not erupted normally in the mouth. The most common reason for it is because of a lack of space in the mouth. In most cases, they have no function in the mouth since they are out of occlusion. Therefore, it is advisable to remove them, the earlier the better, in order to avoid complications in the future.

Odontectomy is the dental procedure entailing the removal, usually with surgical intervention, of impacted tooth, usually the third molars. It is one of the most common minor oral surgical procedures in dentistry.

Some common reasons or indications to remove your impacted teeth are:

  • prevention of tooth decay - Food impaction is relatively common on exposed partially impacted tooth, and may damage the neighboring tooth because of cleaning difficulties.
 tooth decay on the lower second molar, beside the impacted wisdom tooth
 tooth decay on the lower second molar, beside the impacted wisdom tooth
 tooth decay on the lower second molar, beside the impacted wisdom tooth
hidden cavity uncovered after extracting a wisdom tooth
  • prevention of pericoronitis - Inflammation on the operculum (a movable piece of gum tissue partially covering an impacted tooth). For fully erupted and upright third molars or other tooth, an operculectomy may be needed if the operculum is still present long after the tooth has fully erupted, you can read more details in the linked blog post.
an operculum partially covering a third molar
an operculum partially covering a third molar
an operculum partially covering a third molar
  • prevention of periodontal disease - Periodontal pockets may develop from frequent food impaction. This may lead to further gingival attachment loosening ("flabby gums") which will again lead to more food impaction. As periodontal disease progress, it will eventually erode healthy bone and loosen tooth.
a patient with severe bone loss on his lower second molar, aggravated by generalized periodontitis
x-ray of patient on video, with severe bone loss on lower second molar
x-ray of patient on video, with severe bone loss on lower second molar
  • prevention of bone loss - When impacted third molars (wisdom teeth) are taken out before they fully mature, chances are, the bone level behind the second molar will be higher. As the third molar fully matures, it also takes up more space thus resorbing more bone behind the second molar. Younger patients also have better healing than older patients, and so when the fully matured third molar is extracted from an older patient, there is a higher chance that the bone level behind the second molar is suboptimal, which may cause the second molar to be more wobbly because of poor bone support.
bone loss due to presence of third molars, note the bone level of the second molar on the side facing the third molar is already on the level of the second molar's roots
bone loss due to presence of third molars, note the bone level of the second molar on the side facing the third molar is already on the level of the second molar's roots
bone loss due to presence of third molars, note the bone level of the second molar on the side facing the third molar is already on the level of the second molar's roots
bone loss due to presence of third molars, note the bone level of the second molar on the side facing the third molar is already on the level of the second molar's roots
  • prevention of dental crowding - Third molars that are allowed to erupt, especially after orthodontic treatment, may influence relapse (uncontrolled tooth movement after orthodontic treatment).
severe dental crowding exacerbated by presence of third molars
severe dental crowding exacerbated by presence of third molars
severe dental crowding exacerbated by presence of third molars
severe dental crowding exacerbated by presence of third molars
  • prevention of odontogenic cysts and tumors - The same tissue bundle that grows tooth have a tendency to undergo cystic degeneration and may form a dentigerous cyst (a cyst of dental origin). Regular dental checkups with x-rays especially during the teenage years are crucial to monitor such normal or abnormal growths.
dentigerous cyst growing beneath the third molar
dentigerous cyst growing beneath the third molar
dentigerous cyst growing around the lower left third molar
dentigerous cyst growing around the lower left third molar
unidentified cyst growing around the lower left supernumerary premolar
unidentified cyst growing around the lower left supernumerary premolar
  • prevention of premature contacts - A partially erupted impacted third molar, usually the lower, may inadvertently "raise" or make your bite higher due to its positioning. This may affect your bite and might also cause some jaw pain.
erupted part of third molar's crown possibly causing premature bite contact
erupted part of third molar's crown possibly causing premature bite contact
fully erupted lower right third molar possibly causing premature bite contact
fully erupted lower right third molar possibly causing premature bite contact
  • prevention of idiopathic pain - "Idiopathic," or pain coming from an "unknown source", may arise from an impacted third molar even if there is no clear evidence of decay or pathology on the x-ray.
  • prevention of difficult third molar extraction - Immature impacted third molars are easier to remove than fully grown ones! Third molars usually come out almost fully matured by the age of 18. Extracting it prior to that age would be easier since the tooth hasn't fully formed yet. Furthermore, the position of the third molar might transform to a more difficult position for extraction as the tooth matures and the patient ages.
an immature lower third molar / wisdom tooth specimen
an immature lower third molar / wisdom tooth specimen
immature third molars from a 14y.o. patient - half matured lower third molars with crown almost fully formed and no roots formed yet
immature third molars from a 14y.o. patient - half matured lower third molars with crowns almost fully formed with no roots formed yet
immature third molars from a 18y.o. patient - almost fully matured lower third molars with crowns fully formed and roots almost completely formed
immature third molars from a 18y.o. patient - almost fully matured lower third molars with crowns fully formed and roots almost completely formed
2023 panoramic x-ray with insets of 2025 x-rays from a patient with third molars - notice different positioning of third molar on 2023 (angled 45°) vs 2025 (angled 90° almost horizontal)
2023 panoramic x-ray with insets of 2025 x-rays from a patient with third molars - notice different positioning of third molar on 2023 (angled 45°) vs 2025 (angled 90° almost horizontal)

 

Thanks for reading.

A regular dental checkup at least once a year helps prevents bigger problems!

Save your money, prevention is key!

-Doc Jed

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