Impacted tooth extraction is the process of removing teeth that have not erupted properly into the mouth and remain partially or completely covered by the gums or jawbone. This procedure is commonly performed on third molars (wisdom teeth) but can also be necessary for other teeth, such as canines.

Reasons for Impacted Teeth

Permanent and deciduous teeth can become impacted due to:

• Obstructions in the eruption path (thick gums, dense bone structure, pathological formations)
• Trauma
• Jaw crowding
• Tooth misalignment
• Premature loss or retention of deciduous teeth
• Genetic conditions

Typically, wisdom teeth and upper and lower canines are most commonly impacted.

Indications for Impacted Tooth Extraction

1. Risk of Infection: Impacted teeth can partially or fully remain under the gum or jawbone, making it difficult to clean, leading to bacterial infections known as pericoronitis, causing pain, swelling, and infection.

2. Risk of Decay and Periodontal Disease: Impacted teeth can press on adjacent teeth and gums, increasing the risk of tooth decay and periodontal disease. This can lead to gum recession, gum inflammation, and decay in neighboring teeth.

3. Dental Crowding and Malocclusion: Impacted teeth can cause misalignment in the dental arch. Especially third molars (wisdom teeth) can push other teeth out of alignment, leading to malocclusion.

4. Pain: Impacted teeth can cause continuous pain and discomfort in the jaw or facial region, exacerbated by chewing, swallowing, or speaking.

5. Cyst Formation: Cysts can form around impacted teeth, potentially causing jawbone damage and displacement of other teeth. In rare cases, these cysts can turn into tumors.

6. Support for Orthopedic and Orthodontic Treatment: Extraction of impacted teeth may be necessary to facilitate orthodontic treatments like braces to ensure proper tooth alignment.

7. Risk of Fracture and Damage: Impacted teeth are prone to fracture or damage from trauma, increasing the risk of pain and infection.

8. Protecting Adjacent Teeth: Pressure from impacted teeth can damage the roots of neighboring teeth, leading to root resorption and tooth loss.

Impacted Tooth Extraction Procedure

Impacted tooth extraction is typically performed by dentists or oral surgeons. The procedure usually involves local anesthesia, though sedation or general anesthesia may be used in certain cases. The general steps are:

Surgical Procedure:

1. Incision and Flap Creation:

• A small incision is made in the gum, and the gum tissue is lifted to create a flap, exposing the tooth and surrounding bone structure.

2. Bone Removal:

• If the tooth is fully impacted within the bone, the overlying bone is carefully removed to expose the tooth.

3. Tooth Extraction:

• Depending on the tooth's position and size, the tooth may be segmented into smaller pieces for easier removal without damaging surrounding tissues.

4. Cleaning and Disinfection:

• After extraction, the surgical site is cleaned and disinfected to reduce the risk of infection.

5. Flap Closure and Suturing:

• The gum flap is repositioned and sutured. Dissolvable stitches are often used, but sometimes non-dissolvable stitches are required and need to be removed later.

Postoperative Care and Recovery

1. Pain Management:

• Pain relievers and possibly antibiotics are prescribed. Follow the prescribed medication schedule.

2. Cold Compress:

• Apply a cold compress to reduce swelling during the first 24 hours.

3. Diet and Activity:

• Consume soft and cold foods, avoiding hard and hot foods. Limit physical activity and prioritize rest for the first few days.

4. Oral Hygiene:

• Do not spit or brush the surgical area for the first 24 hours. Subsequently, practice gentle brushing.

Impacted tooth extraction is generally a successful procedure, and most patients can return to normal activities within a few days. However, contact your dentist immediately if you experience severe pain, swelling, or bleeding.