Treating Impacted Wisdom Teeth (What Dentists Say)

You hear stories, or you may even know someone, who had their wisdom teeth removed. That's because they had impacted wisdom teeth, a condition that can be very painful and can cause problems with other teeth.

Wisdom teeth are those last teeth in the back of your mouth, the third molars. The grow on both sides and on top and bottom—four in all. They typically emerge ("erupt," in dentist-speak) when you're between the ages of 17 and 25. This time of life is sometimes called the "age of Wisdom," so the teeth that show up during this "age" are "Wisdom teeth."

For some unlucky people, they never come in. Instead, they lay inside your gums at an angle and erupt a little at that angle, pushing against your other teeth and crowding them together. When that happens, you have impacted wisdom teeth.

What Are Impacted Wisdom Teeth?

Impacted wisdom teeth are ones that grow in at an angle, crowding against other teeth. Left untreated, they can cause a lot of pain and damage your other teeth. That's because when they press tight against your molars, they can be difficult to floss and clean properly, which leads to tooth decay and gum disease.

This can be even more difficult if your wisdom teeth have only partially erupted. You can't floss behind it, and it might even be pressed too tightly against the second molar for effective cleaning.

Some of the problems impacted wisdom teeth can cause include:

Damage to other teeth. Wisdom teeth pushing against the second molar could damage it or even crowd all the other teeth. Your teeth will look crooked and overcrowded, and you might think you need braces. You don’t: You’ll need to deal with your wisdom teeth.

Decay. Wisdom teeth are more prone to decay because they're harder to clean. They're even more difficult when they've partially erupted. Bacteria and small food particles can get trapped between the gum and the partially erupted tooth. Not to mention it's hard to floss when the wisdom tooth is pressing so hard against the second molar, meaning that space can't get cleaned.

Gum disease. Not being able to clean out bits of food and bacteria between the gum and partially erupted wisdom tooth can lead to a gum disease called pericoronitis. That can result in swelling of the gums, pain in your jaw, infection, and push discharge.

Cysts. A wisdom tooth develops in a little sac within the jawbone. That sac can sometimes fill with fluid and become a cyst. That cyst can do damage to other teeth, the nerves, and the jawbone itself.

Larger health problems: Believe it or not, the bacteria that live around wisdom teeth — all teeth, actually — can contribute to greater health problems like heart disease, diabetes, and kidney disease. So be sure to floss and rinse every day.

Pain from impacted teeth?

Impacted wisdom teeth don't always cause pain. They don't always present symptoms either. But when things go wrong and they start causing problems like infection, decay, and gum disease, these are some of the painful symptoms you'll experience:

• Red, inflamed gums that are tender to touch and bleed easily.

• Pain in the jaw that makes it hard to open your mouth, chew, or swallow.

• Swelling in that portion of your jaw.

• Bad breath and an unpleasant taste in your mouth.

Treatment options

There’s only one option for treating impacted wisdom teeth: full removal. Whether to remove them, however, remains a bit of a debate among dentists and oral surgeons.

Some dentists and oral surgeons believe they should be removed just to prevent future problems, especially because the complications happen a lot less in younger adults and are more likely to happen to older adults.

But others believe that asymptomatic wisdom teeth should not be removed until there's an actual problem developing when you finally start experiencing some of the problems above. They say there's not enough research to say whether there are problems that develop for older adults.

In all of those cases, extraction is the only solution to the problem. It's done as an outpatient procedure, so you'll go to your dentist's or oral surgeon's office, go through the tooth-removal process and go home. The whole procedure usually takes between 30 and 60 minutes. (You'll probably need to have someone drive you home after the anesthetic.)

There are three different types of extraction, depending on how and whether your teeth have erupted or not.

• Simple extraction: The teeth have erupted, and they just need to be pulled.

• Surgical extraction, soft tissue: They have partially emerged but still need to be cut out of the gums.

• Surgical extraction, bony impaction: The teeth have not erupted and are still embedded in the jawbone. These often require small pieces of jawbone removal as well.

You can either get a local anesthesia, which numbs your mouth, sedation anesthesia to depress your consciousness, or general anesthesia, which knocks you out completely, just like you would have for a regular surgical procedure.

The dentist/oral surgeon will make an incision (cut) into your gums and remove any bone that's blocking access to the tooth. After the tooth is removed, the wound is stitched closed and packed with gauze. There will be some pain and bleeding and some swelling of the jaw muscles for a few days, so you may need to take some pain medication and use ice packs for the swelling. (A bag of frozen peas works great.)

Costs

Depending on your dental practice and where you live, removing impacting wisdom teeth can cost anywhere from $200 to $600 per tooth. Comparatively, removing all four can be a bargain, costing between $600 to $4,000, total. But he more complex the removal, the higher the price.

There is also the initial examination and X-rays, and that can be between $60 and $150.

Other issues affect the final price, including the type of anesthesia you need, local, sedation, or general. The more involved and complicated the anesthesia, the more it will cost. For example, removing wisdom teeth with general anesthesia can cost as much as $4,000 or as little as $1,000 if you had a local anesthesia and simple extraction.

Here are the rough estimates for the removal of all four wisdom teeth.

• Simple extraction: $300 to $1,000.

• Surgical extraction, soft tissue: $800 to $2,000

• Surgical extraction, bony impaction: $1,000 to $4,000

Will insurance cover wisdom teeth removal?

In a word, yes. But only if you had it included in your dental insurance plan to begin with. Not every dental insurance plan provides coverage for wisdom teeth extraction.

If you know you're going to need wisdom tooth extraction, or if you have children who are about to enter that "age of Wisdom," you will want to speak to your insurance provider about your dental coverage to make sure that wisdom teeth extractions are included in your dental insurance plan.

Also, dental insurance plans may have different limits on how much they pay out for all dental care, usually around $1,500 a year. So some people will split the procedure up over two years in order to get more coverage. So, get two removed in November, get two more removed in February. Just make sure to ask your insurance provider about when the "official year" ends on your policy, such as a calendar year versus a fiscal year.

You can also get a dental savings plan that will give discounts on your dental procedures rather than reimbursing you for costs.

Also, some dental insurance plans have a waiting period before wisdom teeth extractions are covered so you don't buy dental insurance the day before your procedure. Be sure to check with your insurance provider to see if there's a waiting period and how long it is.

Finally, if these prices are too high for your budget, we have some suggestions on how to find affordable dental care for you and your family.