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Impacted Wisdom Tooth

The wisdom tooth erupts around age 20 and may become impacted if it fails to emerge. Impacted wisdom teeth are often asymptomatic but can cause issues like pericoronitis, caries, and cysts. Surgical extraction is advised if problems occur, often involving incision and tooth sectioning.

Author: Klas Strindlund • Dental Specialist • Department of Oral and Maxillofacial Surgery • Karolinska University Hospital
Reviewed by: Robert Heymann • Oral and Maxillofacial Surgeon • PhD • Department of Oral and Maxillofacial Surgery • Karolinska University Hospital • Stockholm
6 min read
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    This article is based on an original article in Swedish which can be found here

    BACKGROUND

    The third molar, or wisdom tooth, usually erupts around the age of 20. The eruption can be complete or partial, but the wisdom tooth can also remain in the jawbone. When a complete eruption of the tooth does not occur despite fully developed roots, the tooth is referred to as retained.

    Prevalence

    The prevalence of wisdom teeth in the Swedish population is not entirely clear. In an older study by Hugoson and Kugelberg from 1988, 1/3 of 693 individuals aged 15-80 had all 4 wisdom teeth, and 1/3 were missing all of them. The retention rate was higher in women (44% compared to 30% in men).

    SYMPTOMS

    Retained wisdom teeth are often asymptomatic. However, pathological changes may occur in or around retained wisdom teeth.

    The most common are:

    • Pericoronitis: local inflammation around the wisdom tooth (10–64%)
    • Caries (1.5-31%)
    • Caries/resorption on the second molar (2–5%)
    • Periodontal problems (1-5%)
    • Follicular cyst (1–5%)

    In these cases, surgical extraction may become necessary.

    Pericoronitis

    Pericoronitis is an inflammatory condition of the soft tissues around a tooth during eruption. In most cases, the condition has an infectious cause.

    If the process is localized, antibacterial rinsing with chlorhexidine 0.1% or irrigation with saline under the swollen gum may be sufficient to treat the condition. In the event of localized abscess formation, this should be drained.

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