Your third molars are called wisdom teeth because they are the last set of teeth to grow in, typically between 17 and 21 years of age. Researchers believe that wisdom teeth may have been necessary earlier in our time, when we consumed harder, uncooked foods like nuts and roots. Nowadays, they are vestigial structures, similar to the appendix.

Some people have no wisdom teeth; others have all four. Wisdom teeth don’t necessarily cause problems unless they are impacted. Impacted wisdom teeth grow at an angle that could affect the alignment of your existing teeth. They may also cause damage to your jaw or become infected after erupting only partially.

Dentists can monitor and predict the motion of your wisdom teeth through oral x-rays. However, there are some symptoms you may notice when your wisdom teeth are starting to erupt (and impact).

Types of Wisdom Teeth Impaction

There are four different types of wisdom teeth impaction. These include vertical, mesial, distal, and horizontal impaction.

• Vertical impaction: Vertical impaction does not always require removal. The third molar is mostly vertical but maybe at a slight angle. These teeth have a high chance of erupting without any problem. Vertically impacted wisdom teeth may have to be removed if they put too much pressure on your jaw or back molars.
• Mesial impaction: With mesial impaction, the tooth is aimed towards the front of your mouth. Wisdom teeth undergoing mesial impaction do not always need to be removed, but they may cause problems if they push on your second molar. Mesial impactions have a higher risk of becoming infected because they only partially erupt and are therefore more difficult to clean.
• Distal impaction: Distal impaction means that your third molar is angled towards the back of your mouth. These wisdom teeth may not need to be removed unless they start to push into the bone in the back of your mouth, in which case they will be unable to erupt. Your dentist may monitor your wisdom teeth for a year or two before deciding on their removal.
• Horizontal impaction: Horizontal impaction is perhaps the most serious case of impacted wisdom teeth. The third molar is directed towards your second molar on a horizontal plane and will not erupt to the surface. Horizontally impacted wisdom teeth can cause considerable damage to your other teeth. The procedure to remove them is more complicated and may require removing some bone.

How to Tell If Your Wisdom Teeth Are Impacted

If your wisdom teeth are impacted, you may notice some of the following symptoms.

• Your gums may be red, painful, and swollen.
• You may notice bleeding.
• Your jaw may be painful and swollen.
• It may be difficult to open and close your mouth.
• Glands in your neck and shoulders may be swollen.
• You may experience intense pain in the back of your mouth.
• You might have an unpleasant taste or odor in your mouth, which is the result of bacteria that forms during impaction. The taste and odor may be caused by infection or decay in the tooth.

If you are experiencing these symptoms, you should contact a dentist or oral surgeon. The only way for your dentist to know for sure if your wisdom teeth are impacted is to take an X-ray of your mouth. He or she will be able to identify which direction your wisdom teeth are moving and whether or not they should be extracted.

Wisdom teeth removal is a short procedure lasting between 30 to 60 minutes. Depending on the severity of the impaction, sometimes only a local anesthetic is necessary. Otherwise, an IV sedative or general anesthesia may be necessary.

Some impactions do not need to be removed. Your dentist may also wait to see if these teeth are causing any problems before deciding to remove them.
You should monitor partially-erupted teeth closely and be careful to use proper oral hygiene. Take care to brush in the back of your mouth, where food particles can easily collect and create an infection. Partially-erupted teeth have a high risk of infection because they are difficult to clean.

Dangers of Impacted Wisdom Teeth

Impacted wisdom teeth can create serious problems by damaging your jaw or other teeth. Impacted teeth underneath your gums can form cysts, which may (in rare cases) lead to tumors or cause damage to nerves in your jaw.

If your wisdom teeth push into your existing teeth, they may become misaligned, and you will need orthodontic work to straighten them.
Partially erupted teeth are susceptible to decay and gum disease, such as pericoronitis (the condition in which the gum tissue around your wisdom tooth becomes swollen and infected).