What You Should Know About Impacted Wisdom Teeth

One of the often uncomfortable but common rites of passage from childhood into early adulthood is the emergence of wisdom teeth. Also known as “third molars," these teeth typically begin to appear between the ages of 17 and 21, according to the American Dental Association (ADA). They're called “wisdom" teeth because they often occur as a child is maturing into young adulthood.¹

Why Do We Have Wisdom Teeth?

It may seem silly that we have teeth we don't need, but at one point in human evolution, our Neanderthal ancestors needed extra molars, which we now call wisdom teeth, to chew their food.² Pre-civilization, there were no kitchens and stoves to prepare food for easy consumption; thus, extra molars made it possible to chew their common diet of tough meat, roots and berries.

Evolution moves slowly, however. Many people (though not everyone) still have these vestigial wisdom teeth today, even though human jaws have gotten too small to accommodate them. As a result, in these smaller jaws that tend to eat relatively softer foods, there isn't always enough room, so the wisdom teeth don't have the space to successfully emerge from below the jaw into the mouth.³

What Is an Impacted Wisdom Tooth?

Impacted wisdom teeth are molars without enough space in a person's jaw to come through, and therefore get stuck in a person's jaw or gums. If left alone, they could eventually crowd out the rest of your teeth, as well as cause other problems ranging from infection to bone loss. To prevent those problems, dentists recommend wisdom tooth removal before experiencing potential issues.¹

Impacted wisdom teeth are also enormously common; nine out of 10 people have experienced at least one, according to a publication by the American Association of Oral and Maxillofacial Surgeons (AAOMS).⁴

Types of Impacted Wisdom Teeth

Though it's common to have impacted wisdom teeth, not every impacted wisdom tooth is impacted in the same way. There are four types of impactions, which relate to tooth positioning.³

• Mesial impaction. The most common type of impaction is the result of your wisdom tooth being angled toward the front of your mouth.
• Vertical impaction. This is when your wisdom tooth is in the right place, and even possibly with enough space for an eruption, but it remains trapped below the gums.
• Horizontal impaction. This is when the wisdom tooth is angled on its side and still stuck under your gums. Horizontally impacted wisdom teeth can cause the most pain due to the pressure they place on the teeth ahead of them.
• Distal impaction. The rarest type of impaction, which takes place when a wisdom tooth comes in angled toward the back of the mouth.

Causes of Impacted Wisdom Teeth

Lack of space in the jaw is the most common reason for impacted wisdom teeth. The lack of space in our smaller modern jaws doesn't leave enough room for these third molars to come in easily.

Symptoms of Impacted Wisdom Teeth

There's a myth that if impacted wisdom teeth aren't causing symptoms, they don't need to come out. However, to prevent future problems — ranging from pain to tooth crowding to infection — being proactive and removing them before any problems occur can help.⁴

Of course, in some cases, symptoms do occur before they can be removed. Symptoms of an impacted wisdom tooth can include:³

• Bad breath
• A bad taste in the mouth
• Tenderness or bleeding in the gums
• Pain in the gums or jaw
• Redness or swelling of the gums
• Trouble opening your mouth

Further problems that necessitate removing wisdom teeth immediately include:⁴

• Infections
• Periodontal disease in the neighboring teeth
• Cavities that can't be fixed
• Cysts or tumors in neighboring gums
• When the wisdom teeth are causing damage to neighboring teeth

If the wisdom teeth can effectively break through the gums and don't cause crowding or other problems in the mouth, they might be able to remain, so long as the patient practices good oral health. They may require more frequent dental exams to monitor their health.³

Risks of Impacted Wisdom Teeth

Not removing impacted wisdom teeth can cause a number of health problems, including:¹

• Food getting trapped in gum pockets, leading to the growth of bad bacteria
• Bad bacteria can lead to infection and periodontal disease, swelling, pain and stiffness in the jaw.
• If wisdom teeth come in partially, it can be difficult to floss around and between them.
• Wisdom teeth can crowd out other teeth, causing misalignment of the jaw and bite.
• Impacted wisdom teeth can form cysts that destroy the roots of other teeth and/or the bone of the jaw.

Impacted Wisdom Teeth Treatment Options

The only way to get a good look at the state of wisdom teeth is for a dentist or oral surgeon to perform an X-ray.⁵ Most dentists will recommend this screening to parents of children prior to the age of 17 (on average, around age 16) when most wisdom teeth come in.⁶

If the teeth are determined to be impacted, a dentist will typically make one of two recommendations:⁶

1. Observe and monitor the impacted teeth. If a child gets a dental exam earlier than age 16 and there are none of the worrisome symptoms, dentists will likely monitor until the child is 16 or symptoms develop.
2. Surgical removal. Once it has been determined that a patient needs their wisdom teeth removed, the dentist will refer them to an oral surgeon.

Impacted wisdom tooth removal

If a patient requires wisdom tooth removal surgery, this procedure is typically done by an oral surgeon as an outpatient procedure — meaning, the patient can go home on the same day of surgery.⁷

Depending upon the patient's health profile and comfort level, they will receive either intravenous (IV) anesthesia, sometimes with nitrous oxide (also known as laughing gas) to calm the nerves, or general anesthesia, where you are asleep for the procedure. Once the patient is fully numb or asleep, the surgeon will cut through the gum tissue covering the wisdom teeth, use handheld instruments to extract any bone covering the teeth and remove the teeth themselves. The areas will then be stitched closed.⁷

The patient should not experience any pain during the procedure, though there will be some soreness and swelling for several days afterward, and you may be unable to fully open your mouth.

Impacted wisdom tooth removal cost

For wisdom teeth that are impacted, the price can range between $250 and $1,100 per tooth, though the average is more like $350 to $550.⁸ This is, generally, more expensive than basic wisdom tooth extractions, which can range in price from $200 to $700 per tooth.

CareCredit Credit Card Financing for Impacted Wisdom Teeth

Whether you're getting impacted wisdom teeth removed or you simply need a dental exam, the CareCredit credit card can help you pay for costs not covered by insurance.* Apply today and use our Acceptance Locator to find a dentist or oral surgeon near you that accepts CareCredit. Use the CareCredit credit card, again and again, to pay for your health and wellness needs, and download the CareCredit Mobile App to manage your account, find a provider on the go, and easily access the Well U hub for more great articles, podcasts and videos.

Author Bio

Jordan Rosenfeld has been freelance writing for 21 years about finances, health, education and more. Her work has appeared in The Atlantic, The Billfold, Good Magazine, GoBanking Rates, Daily Worth, Quartz, Medical Economics, The New York Times, Paypal, The Washington Post and more.