A Different Final Four

Did You Know?  All Impacted Wisdom Teeth are Not Created the Same


When a wisdom tooth erupts through the gums and into the open it is known as eruption. However, when a tooth doesn’t fully grow in, it is “impacted” – usually unable to break through the gums because there isn’t enough room.

Many people are quick to assume that when their wisdom teeth are impacted, they require immediate oral surgery. There are four common types of impaction we see at McGann Facial Design. Understanding the different types of impacted wisdom teeth is helpful. Depending on which type you experience, it may or may not require surgery and removal.


Vertical Impaction

Vertical impaction almost never requires wisdom teeth removal since it is an almost normal orientation. The tooth is in an almost near vertical orientation. There is a very high chance they will erupt and fit into the mouth without any problems.

If removal is required, it is due to the tooth causing pressure on the underside of the molar in front or the bones at the back of the mouth. Vertically impacted wisdom teeth can normally be extracted using a local anesthetic. IV sedation would only be required in the case of an extremely nervous patient.


Mesial Impaction

Mesial impaction is the most common type of wisdom tooth impaction, in which the tooth is angled toward the front of the mouth, pushing against the molar in front of it. The angle at which the tooth resides determines whether or not it will become an issue.

Mesial impactions most often lead to a partial eruption, where only the bottom of the tooth pokes into the gums. In many cases, these types of impactions are monitored over time as it might erupt properly.


Distal Impaction

Distal impaction is the least common of the four types of impactions and is the exact opposite of a mesial impaction – the tooth is angled toward the back of the mouth. The need for extraction will depend upon the degree of the angle of the tooth.

If the tooth is angled at or near 0 degrees, it will erupt as normal; but it will always have a slight incline. Your dentist or oral surgeon may wait 1-2 years to determine if it should be removed.

If the angle is closer to 90 degrees, there is a high probability that it will eventually hit bone and not erupt fully. In this case, your oral surgeon will determine if the tooth should be removed or not. Depending on the severity of the impaction, IV sedation or even general anesthesia may be required to undergo the surgery.


Horizontal Impaction

Horizontal impaction is arguably the worst and most painful type of impaction to have. The molar lies horizontally, completely away from the surface and is pushed into the molar next to it. Only an X-ray can determine if you have horizontal impaction, and removal takes the skill and expertise of an oral surgeon. A horizontal impaction lies parallel to the jawbone – without removal, it may damage the surrounding teeth. This type of impaction can result in having to remove some bone, thus the procedure is most commonly performed while under general anesthesia or IV sedation. After removal, most patients will require a prescription for pain killers and possibly antibiotics to reduce the risk of complications during the healing process.


Five Common Signs of Impacted Wisdom Teeth

If you think you suffer from an impacted wisdom tooth, a visit to your dentist or oral surgeon is the only way to tell for sure. Here are five common signs that you may have an impacted wisdom tooth:

1 ~ Gums are bleeding and swollen
2 ~ Swelling around the jaw area
3 ~ Extreme, excruciating pain in the back of the mouth
4 ~ Headaches
5 ~ Swollen neck and shoulder glands


If you think you might be suffering from an impacted wisdom tooth contact us or give us a call at 858.875.8181. Dr. McGann will be happy to examine the problem area and let you know the best course of action.

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