Wisdom Teeth That Makes Pain

What are wisdom or impacted teeth? Impacted teeth are teeth that cannot or cannot erupt into their normal functional position due to resistance from adjacent teeth, bone or surrounding pathological tissue. This situation can lead to pathological conditions that require further treatment. Impacted teeth are divided into two conditions, namely full impaction or total impaction (complete impacted) and partial impaction.

The American Association of Oral and Maxillofacial Surgeons (AAOMFS) in their electronic book entitled Wisdom Teeth states that 9 out of 10 people have at least one impacted tooth (Ebook Wisdom Teeth, AAOMFS, 2021). The condition of impacted teeth is a common condition, which ranges from 0.8-3.6% of the total population in general. Impacted third molars have the greatest prevalence, which is between 16.7% and 68.6%, and it is estimated that around 65% of the world's human population has at least one impacted molar (Silvestri and Singh, 2003; Goyal et al., 2016). The most frequently impacted teeth were the mandibular and maxillary third molars, followed by the maxillary canines and mandibular premolars. This is because the third molars are the last teeth in the eruption sequence, resulting in a lack of room for eruption.

Impacted teeth often make it difficult to maintain oral hygiene because of their position which cannot be reached by a toothbrush, which can cause adverse effects in the long term. Impacted third molars are the most common cause of caries second molars due to food retention. The excess of soft tissue over the coronal part of the partially erupted impacted tooth often causes gum inflammation due to the difficulty in cleaning the pseudopocket area that is formed, thus becoming a place for the development of cariogenic bacteria and periodontal pathogenic bacteria found in the oral flora. Inflammation that appears in the soft tissue around impacted teeth is called pericoronitis. This condition can cause an infection, which, if left untreated, can spread to the head and neck area. Impacted teeth can stimulate the occurrence of cysts and other pathological forms, especially during the formation of teeth. Tooth seeds that experience interference with the formation process so that they become imperfect, can cause primordial cysts and follicular cysts. Another pathological condition that can arise as a result of impacted teeth is an odontogenic tumor. The frequency of odontogenic cysts and tumors arising from impacted third molars is approximately 3%. Other impacts of impacted teeth are periodontal disease of the surrounding teeth, resorption of adjacent roots, cephalalgia, abscess and odontogenic rhinosinusitis.

Preoperative complaints in the form of pain/ache in 50% of patients, 25% difficulty opening mouth/trimus, 16.70%, swelling, and 8.30% dizziness. Various problems caused by impacted teeth are not limited to health problems, but more broadly can reduce the quality of life so that it disrupts people's productivity and will eventually cause economic problems because of the costs involved in handling them.

Impacted teeth that have caused complaints and have the potential to cause pathological conditions and are feared to cause damage and wider problems, are advised to take action. The management of impacted teeth can include operculectomy, autogenous transplantation, initiation of orthodontically guided eruption, germectomy, coronoctomy, and odontectomy. This assessment and alignment also requires coordination with other medical disciplines (ENT-KL, radiology, anesthesia) so that appropriate and comprehensive management of impacted teeth can be provided.

If Friends of Hermina have symptoms as described, don't wait later, please immediately consult a Dentist Specialist for Oral and Maxillofacial Surgery at Hermina Podomoro Hospital.