Wisdom Teeth

Although most people develop and grow 32 permanent adult teeth, many times their jaws are too small to accommodate the four wisdom teeth. When inadequate space prevents the teeth from erupting they are called impacted. This indicates their inability to erupt into the proper position for chewing and cleaning.

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part x-ray of impacted tooth part visual diagram

Types Of Impactions

We will need to see you for a consultation to determine if you will benefit from wisdom tooth removal. A special x-ray of your mouth and jaws (panorex) will be taken to determine if your wisdom teeth are impacted, if there is room for them to erupt, and how difficult it will be to have them removed.

  • Soft Tissue Impaction: There is not enough room to allow the gum tissue to retract for adequate cleaning of the tooth.A photo of a wisdom tooth starting to erupt
  • Partial Bony Impaction: There is enough space to allow the wisdom tooth to partially erupt. However, the tooth cannot function properly in the chewing process, and creates cleaning problems, among others.An example of a wisdom tooth with a partial bony impaction
  • Complete Bony Impaction: There is NO space for the tooth to erupt. It remains embedded in the jaw bone or if even partially visible requires complex surgical techniques for removal. The impacted wisdom tooth may also be in an unusual position and difficult to remove. This situation can also arise when the shape or size of the jaw bone and other facial structures make removal of this tooth significantly more complex.
    Illustration of a wisdom teeth with a complete bony impaction

What if my roots are laying on the nerve?

Coronectomy 

A coronectomy is an alternative to wisdom teeth removal when the roots surround the nerve. This is a technique sensitive procedure that calls for removing the “crown” only and leaving the roots in your jaw. This is to prevent numbness of the jaw and lips. We use our Cone Beam CT x-ray to precisely visualize the roots position in relation to the nerve.

Three things can happen when a coronectomy is done:

  • the bone heals over it and it does not become a further issue
  • the uninfected roots will migrate to the gum surface away from the nerve over time which is an easier & safer procedure to perform (2 – 85.3%)
  • it can get infected and requires removal (1 – 9.5%). At this point, the roots should have migrated away from the nerve and removal is less risky.