Types of Impacted Wisdom Teeth

Once upon a time, wisdom teeth served an important purpose, giving our ancestors extra chewing power to process raw meats and plants. Over time, changes in humans’ diets, jaw structure, and ability to soften food through cooking have made these teeth unnecessary.

Unfortunately, our wisdom teeth haven’t yet gotten the memo on this evolution. In modern times, these third-row molars typically cause more problems than anything else. One of the most common issues to occur is impaction. Impacted wisdom teeth have begun forming, but they remain trapped in the jaw bone or the gums.

There are several types of impacted wisdom teeth, all of which could be causing you pain, discomfort, and additional complications. Fortunately, there are solutions for every situation, and the team at Bergen Oral Surgery is here to help you both understand what’s going on with your impacted wisdom teeth and what to do next.

What Are Impacted Wisdom Teeth?

When wisdom teeth are “impacted” it means that they have formed under the surface of the jaw bone or  gums, but not yet broken through. Wisdom teeth can be impacted for any number of reasons. The jaw may be too small to fit these large molars, stunting their growth, or the teeth may be growing in at the wrong angle.

In most cases, impacted wisdom teeth cause additional issues throughout the mouth. These unnecessary molars can put pressure on the other teeth, jaws, and gums, often causing pain, crowding your other teeth, and causing problems with your mouth and jaw.

Impacted Wisdom Teeth Symptoms

Headache, gum disease, tooth decay, and pain around the tooth are all common complications when your wisdom teeth are impacted. Impacted wisdom teeth can also cause damage to the nearby teeth, jaws, and nerves.  That’s why it’s so important to recognize the symptoms of impacted wisdom teeth and address them quickly.

If you’re not sure how to know if wisdom teeth are impacted, you can look for these common symptoms of wisdom teeth:

• Pain in the jaw or gums
• Redness in the gums
• Swollen gums or along the jaw
• Bad breath
• Gum disease around the tooth
• Cysts or tumors around the tooth
• Changing the alignment of your smile
• Damage to nearby teeth and their roots
• Tingling or numbness
• Difficulty opening the mouth

Impacted Wisdom Teeth vs. Erupted Wisdom Teeth

While impacted wisdom teeth remain hidden below the gums, wisdom teeth that have pushed through both the jaw bone and gums are considered to be “erupted.”

Just like impacted wisdom teeth, erupted wisdom teeth often bring their own set of problems. They can still put pressure on the surrounding teeth and jaws, especially if they grow in at an angle.

In some cases, a wisdom tooth will “partially erupt,” meaning that it pokes through the surface of the gums without fully emerging. Partially erupted or partially impacted wisdom teeth bring an increased risk of infection, as flaps of tissue covering the teeth make them notoriously difficult to clean.

The Different Types of Impacted Wisdom Teeth

There are many different types of impacted wisdom teeth, based on the direction of the tooth and its placement in the jaw. Each type brings different concerns and potential for complications. Understanding what’s going on with your impacted wisdom teeth will help you understand the potential risks—and the solutions that are available to address them too.

Mesial Impaction

The most common type of wisdom tooth impaction is called a mesial impaction. This occurs when the wisdom tooth is growing in at a slight angle toward the front of the mouth. These teeth are often partially erupted, and they can put pressure on the teeth next to them as they grow in. However, you may or may not feel any pain, depending on the severity of the angle and the growth of the tooth.

Complications of a mesial impaction include pain, either generalized or while chewing, crowding of other teeth, damage-causing pressure on the second molar, development of cysts, and nerve damage. If the tooth is partially erupted, you may also experience gum disease, bad breath, and bleeding or tenderness in the gums around the tooth.

Vertical Impaction

A vertical impaction is what happens when the tooth is aligned in the ideal position for eruption, but simply doesn’t grow through the gums. Vertical impaction typically occurs when there isn’t space for the tooth to erupt, whether because of the size of the jaw or other factors.

Vertically impacted wisdom teeth are the least likely type of impacted teeth to cause problems, as they are properly aligned in the mouth. However, because the tooth remains under the surface rather than just the roots of the tooth, it can put pressure on the roots of the adjacent teeth. This may result in pain and root damage.

Horizontal Impaction

Horizontal impaction occurs when the wisdom tooth grows in perpendicular to the surrounding teeth. It typically points toward the front of the mouth, but unlike a mesial impaction, in which the tooth grows at an angle, the tooth is turned fully sideways in the jaw.

Because a horizontal impaction is growing directly into the roots of the adjacent teeth, it brings an extremely high risk of damage to the surrounding teeth. When wisdom teeth are horizontally impacted, they must be addressed quickly to minimize this damage and other complications.

Distal Impaction

A distal impaction occurs when the tooth grows at an angle, similarly to a mesial impaction. However, in the more rare impaction type, the tooth grows toward the back of the mouth rather than the front.

With a distal impaction, extraction isn’t always necessary. It often depends on the angle of the tooth, the rate of growth, and whether it is partially or fully impacted. Wisdom teeth that are distally impacted can also cause gum infections and cysts, and should be addressed.

Soft Tissue Impaction

With many impactions, the tooth is still at least partially surrounded by both gums and the jaw bone. With a soft tissue impaction, the tooth has emerged from the jaw bone, but hasn’t quite broken through the surface of the soft tissue gums.

While soft tissue impaction is the mildest form of wisdom teeth impaction, it can still cause concerns like gum irritation, infections, and pain while chewing.

Partial Bony Impaction

With a partial bony impaction, the wisdom tooth does not fully emerge from the jaw bone. Partial bony impactions may also be partially impacted in the gums, increasing the risk of gum disease and infection at the surface. Partial bony impactions often cause pain and put pressure on the other teeth.

Complete Bony Impaction

A complete bony impaction means that the tooth is still fully enveloped in the jaw bone. This typically occurs when there is no room for the tooth to erupt. Fully impacted wisdom teeth can result in cysts forming in the jaw bone, joint pain, and damage to other teeth.

Do Impacted Wisdom Teeth Need to Be Removed?

Whether they are fully erupted or impacted, not all wisdom teeth require extraction. A knowledgeable oral surgeon will consider a number of factors, including the size of your mouth, the angle and rate of the tooth’s growth, and whether they are fully or partially erupted.

Even if your wisdom teeth aren’t currently causing you any problems, they may still pose long-term risks. Evaluation by a professional is key to predicting those risks and, in many cases, monitoring your situation as it evolves.

If Your Mouth is Too Small for Your Wisdom Teeth

In the days when wisdom teeth were necessary for survival, the human jaw was much larger. Over time, our jaws have shrunk, allowing less space for wisdom teeth to fit properly in the mouth. In fact, a small mouth is the number one cause of impacted wisdom teeth as well as the number one reason to have them removed.

A jaw that is too small could prevent your wisdom teeth from properly erupting, causing them to become impacted. Erupted or impacted, the limited space makes the teeth more likely become crowded. In a small mouth, wisdom teeth often push the other out of alignment, causing additional concerns like bite issues and damage to those teeth.

Your dentist or oral surgeon will typically assess your wisdom teeth with x-rays. From these images, they can determine the size and angle of your wisdom teeth, as well as the available space for growth. Removing wisdom teeth early is sometimes critical to preventing crowded mouth from ever occurring, reducing or eliminating the risk of long-term damage.

Sinus Problems

Because of their location near the maxillary sinuses, impacted wisdom teeth in the upper jaw can contribute to sinus problems. Pressure on the sinus cavities from the teeth can lead to pain, discomfort, and congestion. Even more, bacteria from the teeth—especially if partially erupted—can spread to the sinuses, causing infections.

Gum Inflammation

Pericoronitis, or gum disease around wisdom teeth, is a common issue for anyone with impacted wisdom teeth. Because the wisdom teeth are located so far back in the mouth, they’re not easy to clean. For a partially impacted wisdom tooth, in which some of the tooth is exposed, good oral hygiene is even more difficult.

Bacteria around the tooth can easily impact the gums, causing inflammation and infection. Swollen gums, a common symptom of impacted wisdom teeth, can also cause pockets of space between the teeth and the gums where food particles and bacteria become trapped. The risk of infection and tooth decay is high, and it can easily spread to other teeth. In most cases, removal of the wisdom teeth is the only way to eliminate that risk.

Cysts

Cysts occur when fluid builds up around the impacted tooth, forming a sac around the top of the tooth. Cysts can be extremely painful, causing swelling and tenderness in the jaw and surrounding tissue. 

However, many cysts are asymptomatic, and you may not even notice an issue. While asymptomatic cysts are not painful, they take up valuable space in the jaw and can quietly cause damage to the surrounding teeth, and jaw. In the worst cases, cysts can carve out a hollow space in the jawbone, permanently damaging the jaw and nerves.

Are Impacted Wisdom Teeth Harder to Remove?

Yes, impacted wisdom teeth are typically more complicated to remove than fully erupted teeth. However, advancements in dental technology and oral surgery make the removal of even deeply impacted wisdom teeth much more manageable—and comfortable too.

A skilled oral surgeon is key to removing the tooth with minimal complications. The NJ oral surgeons at Bergen Oral Surgery, for example, have a combined 70+ years of experience in wisdom teeth removal in NJ.  Our dual-degree surgeons are expertly trained in both medicine and oral surgery to provide the best care—no matter how impacted your wisdom teeth may be.

Don’t Ignore Impacted Wisdom Teeth Symptoms

If you suspect that your wisdom teeth are fully or partially impacted, don’t wait to call an oral surgeon. The sooner you deal with your impacted wisdom teeth, the better your chances of avoiding long-term complications from teeth crowding, tooth decay, and permanent damage to the jaw and nerves.

The team at Bergen Oral & Maxillofacial Surgery offers consultations to review your situation and help you understand the many types of impacted wisdom teeth. They’ll recommend the best possible solution for your oral health, whether that’s monitoring the situation or scheduling an extraction.

To learn more about your options, call one of our four locations in Franklin Lakes, Hackensack, Ridgewood, and Westwood. We’ve been providing expert oral care to the people of Bergen County for more than 70 years, and our offices have a combined total of 2,000+ Google reviews and a nearly five-star rating.

To set up an appointment, call or text us at (866) 250-2667 or request an appointment online.