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Dr. Joyce Ting
Impacted wisdom teeth

Wisdom teeth usually erupt when a person is at the age of 18 to 25. In the process, some wisdom teeth may not have enough space to fully emerge, resulting in impacted teeth. This is more common for wisdom teeth on the lower jaw.

Partial eruption of a wisdom tooth may cause accumulation of plaque around the soft tissue surrounding the crown. Pericoronitis may develop. Symptoms include pain, fever, swelling and/or limitation of mouth opening. Medication can be prescribed to treat the inflammation and to relieve pain for the short term. For long-term management, it requires meticulous oral hygiene and regular monitoring, or surgical extraction of the impacted wisdom teeth.

Prevention is better than cure. As impacted wisdom teeth are difficult to clean and food debris will cause plaque build-up in the gap between an impacted tooth and the adjacent molar, there will be high risk of caries or periodontal disease affecting both teeth. Therefore, surgical extraction of an impacted wisdom tooth is usually recommended as a preventive measure.

Radiographic examination is mandatory to assess the difficulty of surgery and ascertain the positions of the inferior alveolar nerve and the impacted tooth. If the nerve and the tooth are too close, there will be greater risk of trauma on the nerve. The risks and benefits must be weighed up prior to surgery. In some cases, coronectomy is a preferred treatment to minimize risks. It involves surgical removal of the crown of an impacted wisdom tooth, leaving the root untouched. Alternatively, the impacted tooth can be extracted by experts such as oral maxillofacial surgeons.

The above information is provided by Dr Ting Pong Jor, Joyce