Hello, this is Dr. Virginia Ellis over here at Virginia DDS Dental Corp. Today, we are going to be talking about impacted teeth. All right. We've had a lot of questions about that, so I'm going to be answering them.
What is an impacted tooth?
Basically, an impacted tooth is a tooth that is partially out of the gum line or way underneath the gum line. I have an example here. It might look something like this. Let me look at this model. Pretend this is the pink gum line and the tooth is underneath. If you look over here, that's an impacted tooth. Impacted means it's still underneath the gum line and erupting. Partially erupted means part of it is out. Wisdom teeth sometimes show part of the tooth out, which is a partially erupted tooth. If it's underneath the gum line, underneath the bone socket, it's considered an impacted tooth.
What causes a tooth to become impacted?
Basically, lack of jaw space. If you have a small jaw or too many teeth causing crowding, they can get stuck underneath the gum line and won't come out. So, it's basically a tooth stuck due to not enough space.
What are the symptoms of an impacted wisdom tooth?
Often, you don't have symptoms, but sometimes you can. Many people can walk around without knowing they have impacted teeth. When they need to be taken out, people often wait until they're in pain. At that point, they might call me because of swollen gums, throbbing, or infection. Swelling is a big indicator, especially on the inside back part of the gums. That's a symptom of an impacted wisdom tooth.
What is the difference between a partially erupted and impacted wisdom tooth and a fully erupted wisdom tooth and a partially erupted wisdom tooth?
I just explained that. Partially erupted means it's partially out, and you see part of it out of the gum line. Fully unerupted means it's underneath the gum line on the bone socket.
How are wisdom teeth diagnosed, and what does a severely impacted wisdom teeth x-ray show?
They're diagnosed during a dental checkup when we look at your X-rays. Many times, we'll see it on the x-rays, showing the teeth underneath the gum line and bone socket. We'll advise you on when they should be examined and removed. Most of the time, they do need to be taken out.
How does the removal process for impacted wisdom teeth work?
You visit the oral surgeon for an initial consultation, where they explain the risks, alternatives, and benefits. They'll offer options for anesthesia, whether you want to be awake or asleep. You'll return for a second visit for the procedure. The first visit covers evaluation and anesthesia options, as well as risks and benefits. The second appointment is for the procedure. If they're impacted and stuck underneath the gum line, they'll cut the gum line (you'll be numb), gain access, and sometimes remove the tooth in one piece. If it's really impacted, they might have to section it and remove it in pieces.
What is the cost of impacted wisdom tooth removal and does insurance cover it?
Many insurances cover it, but every case is different. If you've used your insurance for other things and don't have enough coverage, obviously, call the office for a pre-estimate. The cost varies from $200 to $1,100 per tooth, depending on the type of anesthesia, the situation, and location. The most expensive part is the anesthesia. Especially when teeth are impacted underneath the gum line and bone socket, it's best to have sedation, like IV sedation. They put an IV in, and you have a good nap. You wake up half an hour to an hour later, and it's done. I recently called an oral surgeon, and they charge about $2,700 for IV sedation to remove four teeth, but that's only for the anesthesia. Remember, anesthesia is the most expensive part. Overall, expect a couple of thousand dollars. I would say $3,000 to $4,000 for wisdom teeth is a good estimate. This doesn't consider insurance coverage. Call the office for a consultation, which will help you.
What should patients expect during and after an impacted tooth removal?
When they tell you to come in, if you decide not to have IV sedation, usually they'll ask you not to eat or drink for 8 to 10 hours prior to the procedure to reduce the risk of vomiting and choking. They'll perform the procedure, and you'll take some time to wake up. Everyone wakes up differently. Some wake up right away, while others take longer to recover. Afterward, you take about four or five days off. The fourth day is when you have the most swelling with most surgeries. The key is to apply a lot of ice. If you have wisdom teeth removals where your teeth were impacted, apply a ton of ice. If you don't, you'll swell up and look like a chipmunk. If an area swells up, isn't healing, or looks infected, oral surgeons will provide their cell numbers or after-hours numbers for any complications.
How do horizontal wisdom teeth differ from other impactions?
Horizontal wisdom teeth can be positioned differently, facing in various directions, sometimes literally horizontal. They are harder to remove, which is why doctors, especially oral surgeons, are trained for these cases.
What is an impacted K9 tooth and how is it treated?
This is crucial, especially with children as they're growing. We take X-rays every six months until all of their teeth are out or they're out of braces. The position of teeth in children changes every six months, and we need to catch canine impaction. The canine is the pointy tooth that may be stuck under the gum lines. If they're shifting, they can push on a root and cause it to shrink or resorb, risking loss of front teeth. If caught early, we inform the orthodontist and oral surgeon. They often cut the gum line, bond a metal button, attach a chain, and realign the canine tooth to go in the right direction. A canine impaction is a tooth stuck under the gum line and bone socket, likely needing surgical repositioning.
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