Impacted Wisdom Teeth: Its Classification and Diagnosis

Wisdom teeth are often classified as the third molar teeth. Molar teeth are the ones which are employed in the chewing process and found farthest into the back of the mouth. There are normally first, second and third molar teeth in a person. The wisdom teeth erupt at the age of late teens or early twenties.
Since it is the age when a person matures in most of the cultures, the term wisdom teeth has been named. There are four wisdom teeth namely the lower left, lower right, upper left and the upper right. Impacted tooth normally refers to one which has failed to erupt fully into its probable position. This failure results as there is not enough space in the jaw bone at the back for the accommodation of the wisdom tooth or there is improper angulation of tooth.

The impacted wisdom teeth normally erupt at the age of 45-55. This makes them tough to extract the teeth as well as a longer time for the healing process. The impacted wisdom teeth can be classified in two ways. One classification refers to the direction in which the impaction occurs and the other is the degree to which the tooth is impacted.

The first classification is into mesial, distal, vertical and horizontal types. The most common one, the mesial or the angular type, refers to impaction where the tooth is angled forward towards the front of the mouth. Distal refers to the tooth being angled towards the throat. Vertical refers to the tooth being angled towards the head and horizontal towards sideways.

The second classification is into soft tissue and bone impactions. In case the tooth is simply covered by the gum, it is soft tissue, if it is covered by gum as well as some of the jawbone, it is partial-bone impaction and if it is covered by gum and the entire jawbone, it is complete-bone impaction.

The options left are extraction or retaining them. But only a few people (possessing large jaws) succeed in retaining it and care for them similar to other teeth. The blacks and the Africans are able to retain them since they have enough space in their jawbone for the complete eruption of the wisdom teeth. But for most of the other people, it is necessary for their wisdom teeth to be removed or else it may lead to serious problems.

The commonly occurring problems associated to wisdom teeth are cavities, facil abscess (cellulitis), gum inflammation (pericoronitis), crowding (occlusal malaligment), cyst, numbess (parathesia) and in rare cases, the teeth’s infection can move downwards causing airway obstruction and sudden death in some people. These rare occurrences have been 3-5 times in Texas every year. Besides, as indicated by the Chinese medicine, the four wisdom teeth refers to the four heart chambers, and a problem in once can produce a block in the energy system leading to heart trouble.

These teeth normally results in trouble while there is a stressful situation like changing homes, final exam, pregnancy, etc. The right time for getting the wisdom teeth removed is when they are nearly two thirds of their sizes. This will be normally at the age of late teens or early twenties. There are two common modes for the surgical removal of these teeth at present. The common recommendation is to go for the removal of all the four teeth through intravenous sedation and local anesthesia. The other option is to remove one side (upper and lower) at a time between a gap of 3-6 months under local anesthesia.