Wisdom tooth impaction refers to a situation where a third molar (wisdom tooth) does not fully erupt into its normal position in the mouth. This commonly occurs because of lack of space, abnormal angulation, or obstruction by adjacent teeth, bone, or soft tissue.
Types of Impaction
1. Mesioangular impaction – Tooth is tilted forward toward the front of the mouth (most common).
2. Distoangular impaction – Tooth is tilted backward toward the throat.
3. Vertical impaction – Tooth is upright but fails to erupt fully.
4. Horizontal impaction – Tooth is lying flat, parallel to the jawbone.
5. Soft tissue impaction – Crown is covered only by gum tissue.
6. Bony impaction – Crown is partially or fully encased in bone.
Symptoms
Pain or swelling in the back of the mouth
Gum infection (pericoronitis)
Difficulty opening the mouth
Bad breath or bad taste
Pressure on adjacent teeth
Sometimes no symptoms (found incidentally on X-ray)
Potential Complications
Recurrent infections
Cyst or tumor formation around the tooth
Damage to adjacent teeth or roots
Crowding or shifting of other teeth
Jaw pain or stiffness
Diagnosis
Clinical examination of gums and bite
Dental X-rays (OPG or CBCT) to assess tooth position and proximity to nerves or sinuses
Management
Observation – If asymptomatic and easy to clean.
Operculectomy – Removing gum tissue overlying a partially erupted tooth if only minor obstruction exists.
Surgical extraction – Most common treatment
