Is Oral Surgery Always Necessary To Fix Impacted Teeth?

If someone says he has an impacted tooth, he is almost always going to be talking about a wisdom tooth, explains Dr. A. Gerald Michels at Hillcrest Family Dental Care in San Diego, California. When a tooth becomes impacted, it means that instead of erupting as it should, the tooth has gotten stuck in the bone, says Michels. Unfortunately for people who have a fear of surgery, there are very few options for dealing with an impacted tooth beyond having oral surgery to remove the tooth. The only other common option is to simply leave it alone.

The term oral surgery can mean different things to different people,but in the world of general dentistry, Michels says the term is usually used when referring to the removal of one or more teeth. “You also have some oral surgeons who are maxillofacial surgeons who do implants and can work on your sinuses,” Michels says. “But as general dentists, we call oral surgery the removal of teeth.”

Although it is the patient’s choice whether or not to have impacted teeth removed from the mouth with sedation and oral surgery, a dentist is most likely to recommend that course of action over leaving the impacted teeth in the mouth, according to Michels. Impacted teeth that are left unattended to will exert a forward pressure on the other teeth in the mouth, causing the front teeth to become more crowded or crooked in some cases. For people who previously wore braces or had orthodontia treatments, having one or more impacted teeth that push on the mouth can undo all the work that was previously done by an orthodontist

Of course, dental alignment is not the only reason why a dentist is likely to recommend oral surgery and sedation to patients with impacted wisdom teeth. It turns out that when a wisdom tooth is only partially erupted, there is usually a layer of tissue that remains over the top of the impacted tooth. Because this layer of tissue gets in the way, the tooth can be very difficult to keep clean. Having a tooth that is difficult to keep clean can lead to infection, which is the last thing anyone would want to happen in his mouth. “So most of the time, we recommend taking them out,” Michels explains.

Although the course of treatment for an impacted tooth is fairly defined, the causes of an impacted tooth are less easy to pinpoint. When it comes to impacted teeth, no amount of brushing or flossing can prevent the problem from occurring. Teeth become impacted due to the way they are erupting or growing into the mouth, which has nothing to do with how well someone keeps up his oral hygiene regimen.

It is important to note, though, that oral surgery is not always required to fix wisdom teeth in every single case. Although that is the most common course of action, there are some rare cases when a wisdom tooth can erupt in proper alignment. In those cases, Michels says that as a dentist, he would recommend his patients avoid the sedation and oral surgery and just “leave them alone.”

Michels says that if a patient has impacted teeth but does not want oral surgery—either out of fear of the surgery or for another reason—then he or she can always have the impacted teeth left in the mouth. “I have my wisdom teeth, and I am 60 years old. They have never bothered me,” Michels says. “They have always stayed where they are and they have never caused me any trouble.”

Just like anything else in life, there are some people whose impacted teeth will crowd the mouth and cause pain, and some whose impacted teeth will hardly be noticed at all. Michels says that if you took a group of 10,000 individuals with impacted wisdom teeth, some would have trouble and pain and some would not.

Although many patients are willing to deal with the dull and achy pain that comes with impacted teeth, some are not. Especially for teenage patients who have already gone through orthodontics in the past, Michels says that having impacted teeth removed is usually the more commonly recommended course of action to prevent any crowding from taking place. “So it is a question of whether you’re getting them when you are young, and whether one of them is bothering you,” Michels says. “Do you want to get them out when it is easier to get them out, or not?”

*Disclaimer: The information on this website is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.

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