Impacted tooth removal

An impacted tooth is one that fails to erupt into the dental arch within the expected developmental window. Because impacted teeth do not erupt, they are retained throughout the individual’s lifetime unless extracted or exposed surgically. Mr Luke Cascarini has considerable experience in oral and maxillofacial techniques and is qualified in both disciplines of medicine and dentistry.

Causes of impacted teeth

In layman’s terms, a tooth may become impacted when you mouth doesn’t have enough room for it. Common causes are adjacent teeth fighting for supremacy, dense overlying bone, excessive soft tissue or a genetic abnormality. In addition, and specifically in the young, this lack of space can be due to other factors such as premature loss of milk teeth and the early arrival of primary teeth emerging through the gums. Sometimes it happens for no obvious reason.

Symptoms of impacted teeth

There may be no symptoms of a fully impacted tooth. However, symptoms of a partially impacted tooth may include:

• Occasional difficulty opening the mouth
• Bad breath
• Prolonged headache or jaw ache
• Redness and swelling of the gums around the impacted tooth
• Visible gap where a tooth did not emerge
• Swollen lymph nodes of the neck (rare)

Complications of impacted teeth

An impacted tooth may push on the next tooth, which pushes the next tooth and so on, causing a sort of domino effect, which can lead to additional problems further down the line. Other complications are as follows:

• Abscess of the tooth or gum area
• Chronic discomfort in the mouth
• Infection
• Malocclusion (poor alignment) of the teeth
• Plaque trapped between teeth and gums
• Nerve damage in rare cases

Diagnosis

Impacted teeth are usually first diagnosed by your dentist, who will decide whether you should be referred to an oral surgeon for assessment and to consider removal. Impacted canine and premolar teeth are usually determined at an early age. Occasionally, impacted teeth are first noticed when the cyst becomes very large and shows up on an X-ray. If you have severe pain in the back of your mouth with swelling, you may have pericoronitis (inflammation).

Treatment

As indicated above, impacted teeth are often treated by surgical removal. Thankfully, however, this is not always the case. Other treatment options may include the following:

• Waiting and monitoring: If your impacted tooth isn’t causing any symptoms, your dentist may suggest a wait-and-see approach, with regular monitoring so that they can see if any problems develop. Removal may still ultimately be required, but in many cases this cautious approach allows the spectre of surgery to be avoided. This approach of course requires that you go in for regular dental check-ups.
• Eruptions Aids: When the canine teeth are impacted, eruption aids may be used to get the tooth to erupt properly. These aids may include braces, brackets, or by extracting baby or adult teeth that may be blocking the canines. These methods are most effective when performed on younger people. If eruption can’t be achieved, then the impacted tooth will need to be removed and replaced with a dental implant or bridge.

Surgery

If you’re experiencing pain and other unpleasant side effects from an impacted tooth, extraction surgery may be the only cause of action. This is usually done as an outpatient procedure, meaning you can go home the same day you have the removal which usually takes between 45 and 60 minutes.

For those scared by the thought of having a tooth removed, don’t be. Although it may seem a cause for anxiety, tooth extraction is relatively painless and the recovery time is quick, providing you follow the advice given by Luke on the day.

Anaesthesia options are 3-Fold. Most common is local anaesthesia which is a simple injection to numb the affected area. If you feel particularly worried, Luke may also offer you intravenous anaesthesia, which has the effect of making you calm and relaxed. Thirdly, if the position of the tooth makes surgery more complex, the final course of action would be a general anaesthetic, any underlying medical conditions notwithstanding.

To commence the procedure a small incision is made in the gum. Bone may then need to be removed around your tooth or the tooth itself cut before it can be extracted. Once the tooth is removed, a blood clot will usually form in the socket. This will be packed with a gauze pad to stop the bleeding. In some cases, a few stitches may also be necessary.

Recovery and Aftercare

Though aftercare may differ based on the type of extraction and location of your tooth, you can usually expect to heal in a matter of 7 to 10 days. It’s important to do what you can to keep the blood clot in place in the tooth socket. Dislodging it can cause what’s called ‘dry socket’, which can be painful.

The following steps help ensure that your recovery goes smoothly.

• Apply an ice pack to your cheek for 10 minutes after the procedure to reduce swelling.
• Take medications as prescribed, including over-the-counter painkillers like paracetamol.
• Rest and relax for the first 24 hours. Do not jump immediately into your regular routine.
• Brush and floss your teeth like normal, but be careful to avoid the extraction site.
• The day after the procedure, eat soft foods, such as yogurt, pudding and applesauce. As you heal over the next few days, you can slowly reintroduce other foods into your diet.

Find out more about surgical teeth removal.

How can I pay for surgical wisdom tooth extraction?

If you have private medical insurance, you will almost certainly find they will cover you fully for impacted wisdom tooth removal. Your policy should cover hospital costs, surgeon’s fees and, where applicable, anaesthetist’s fees. The insurance code for surgical removal of impacted tooth or teeth is F0910.

If you do not have medical insurance but want to have this treatment carried out privately with Luke, there are a number of options to pay for yourself – please contact us to find out more.