What is an impacted tooth?
A tooth that is blocked by another tooth or dense bone and is therefore prevented from entering and assuming its normal place in the mouth is called an impaction.
What harm do impacted teeth do?
- A cyst can form around the crown of the impacted tooth and cause destruction of surrounding bone and damage to other teeth and nerves in the area.
- Whenever saliva can reach the impacted tooth, decay may occur and, since such cavities cannot be filled, severe toothache can result.
- Bacteria in the saliva may cause infection around the crown of the impacted tooth. This infection may spread to the cheek, throat, or neck with pain and stiffness of the jaws.
- A benign tumour may develop in the wall of a cyst surrounding the impacted tooth. This may require surgical treatment which is more complicated in order to correct. Unfortunately, impacted teeth can be “dormant” for years, but then cause problems and pain at an unexpected and inconvenient time. The removal of impacted teeth may therefore be considered treatment and most surgeons recommend their removal even if they are not causing trouble now.
- Your orthodontist may recommend preventative removal for space or crowding considerations.
What is it like to have an impacted tooth removed?
Since the impacted tooth is usually beneath the gum surface and encased in bone, we consider its removal an operation in every sense of the word, comparable to a tonsillectomy. This is not said to frighten the patient, but rather to give better understanding about certain features regarding careful preoperative preparation and the need for good post-operative care.
In order for us to minimize potential complications, it is necessary that you inform us of any general health problems, allergies, and medications that you are taking or abnormal health conditions. Even if you think it is a minor condition, please do not hesitate to mention it.
Several techniques ranging from local anaesthesia, IV sedation, to general anaesthesia are used to ensure that the patient is comfortable during surgery. Drugs that are used in our sedation and anaesthetic techniques are contraindicated in pregnancy. Your surgeon will choose the method he feels is most suitable for your particular case. Depending on the difficulty of the case, the procedure may last from twenty to sixty minutes. The removal of an impacted tooth is accomplished by making an incision in the gum to expose the tooth and the surrounding bone. Some of the bone must usually be removed from the tooth before the tooth is extracted.
In some instances, the tooth may be cut into sections to assist in the removal. The area from which it has been removed is cleaned thoroughly and stitches are placed to restore the normal contour of the soft tissues. These stitches will assist in the control of bleeding; however, there may be some slight oozing which should stop within 24 hours.
Lower impacted teeth often rest near the main nerves to the lower jaw and the tongue. Occasionally, in spite of all precaution, one of these nerves may be bruised. This may result in numbness or tingling of the lower lip, chin, teeth or tongue on the affected side of the jaw. This effect is seldom a permanent one, improving as the nerve repairs itself. The duration of the numbness cannot always be predicted and, in rare cases, it may last months or even be permanent. The nerves involved are purely sensory, so there is no change in one’s appearance, speech, or eating ability.
Upper impacted teeth lie against the wall of the sinus. We will use great care to see that no injury occurs to this area, but occasionally the thin wall of bone is penetrated and blood seeps into the sinuses. If this occurs, your surgeon will advise you and prescribe therapy to clear up this condition promptly.
In extremely rare instances, the unusual position of the tooth or cyst has weakened the lower jaw and the removal of the impacted tooth may result in the risk of jaw fracture. In almost all cases this can be predicted before surgery and your surgeon will inform you of this possibility. Every possible precaution is always taken to prevent this occurrence.