A human adult has 32 teeth in total. However, the final four ‘Wisdom Teeth’ or ‘Third molars’ are the last to erupt. They derive their name from the fact that they appear when a person is ‘Older’ or ‘Wiser’- around the ages of 17-25 years. Interestingly, research shows that up to 35% of the population globally do not have one or all of their four wisdom teeth.

Impacted Wisdom Teeth:
The wisdom teeth usually cause mild discomfort while erupting. Studies however show up to 24% of people globally have an ‘impacted’ tooth which means the tooth does not have enough space in the jaw to come out.
This problem has become more widespread due to the smaller jaw size in humans as compared to our ancestors. Commonly, the wisdom teeth of the lower jaw (mandible) are more affected by impaction than its upper jaw counterparts.

Symptoms of an impacted tooth:
• Pain in the jaw, face, ear or neck corresponding to the side of the impacted tooth.
• Swelling within the oral cavity and/or on the face corresponding to the side of the impacted tooth.
• Swollen, bleeding gums
• Altered taste sensation, bitter/ foul taste in the mouth
• Painful or reduced jaw opening
• Oral malodor – bad breath
• Excessive salivation

Common issues arising from impacted wisdom teeth are:
• More chances of decay and gum disease in the area of the wisdom tooth.
• Pericoronitis: Inflammation of the gum tissues over the wisdom tooth, causing pain, difficulty in chewing and closing the mouth.
• Problems to the adjacent healthy teeth: Impacted wisdom teeth might commonly damage the adjacent healthy teeth. Due to lack of space, these wisdom teeth can cause pressure on the adjacent teeth, sometimes fracturing a part of the healthy tooth, cause decay, gum infection or loosening of the tooth.
• Overcrowding of the other teeth: Wisdom teeth may push the other already erupted teeth while erupting or trying to erupt. This causes a change in the alignment of the teeth, overcrowding of the front teeth, protrusion of the front teeth, change in aesthetic appearance of the teeth, etc.
• Cyst formation: Rarely, an untreated wisdom tooth may lead to the development of a non-cancerous (benign) cyst. This may cause pain, discomfort or swelling and is treated by removal of the wisdom tooth along with the cyst (excision) and some amount of bone.
• Localised infection or facial swelling: Pus collection within the tissues around the wisdom tooth can spread to adjacent healthy tissues of the jaw and/or face causing a ‘Space Infection’. In addition to facial swelling, pain, difficulty in mouth opening (trismus), altered taste sensation, etc., it might also cause systemic symptoms such as fever (pyrexia), lymph node enlargement (lymphadenopathy) and in severe cases, airway obstruction.
Treatment modalities for an impacted wisdom tooth:
• Dentists usually advise the removal or extraction of the wisdom tooth if the diagnosis is confirmed with an X-Ray.
• In the case of an infection, a course of antibiotics and anti-inflammatory drugs are given before the extraction.
• Extraction is commonly done under a local anesthetic (general anesthetic might be used in some selected cases).
• Pain, swelling and discomfort following a wisdom tooth extraction usually resolve in less than 3-7 days.

From the above article, one can understand the importance of getting an impacted wisdom tooth treated by the dentist. These issues can be pre-diagnosed and treated immediately by visiting a dentist every 6 months.
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