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Wisdom Tooth Cavity: Risks (Pain, Infection, Damage) and Extraction Indications
Complications of Untreated Wisdom Tooth Decay
- Pain: Pulpitis → periapical abscess → severe, radiating.
- Infection spread: Cellulitis, Ludwig's angina (airway emergency), osteomyelitis.
- Adjacent tooth damage: Distal caries on 2nd molar, periodontal bone loss.
- Cyst/tumor: Dentigerous cyst, ameloblastoma from impacted follicle.
Impacted Wisdom Teeth
- Classified by angulation (mesioangular, vertical, horizontal, distoangular) and depth.
- Partial eruption → pericoronitis (recurrent infection under operculum).
Extraction Indications
- Symptomatic (pain, infection, cyst)
- Pathology on imaging
- Orthodontic/periodontal compromise of 2nd molar
- Prophylactic? Controversial — AAOMS: consider if high risk; NICE: not routine.
Procedure
- Oral surgeon vs. trained dentist
- Anesthesia: local, IV sedation, GA
- Risks: IAN injury (lip numbness), lingual nerve, dry socket, fracture
Not all wisdom teeth need removal. Individualized assessment by dentist/surgeon.
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