After Exposure of an Impacted Tooth

What is an Impacted tooth?

All teeth are formed deep within the jawbone. As the root develops most teeth travel toward their future place in the dental arch. This movement is called eruption. If a tooth travels in the wrong direction or is blocked by another tooth or dense bone, it is said to be impacted.

What harm do impacted teeth do?

Since it is not normal for a tooth to remain beneath the surface after the age of 18 or 21, it is easy to understand why difficulties develop. Whenever saliva can reach the crown- and this may happen even though the impacted tooth cannot be seen in the mouth -decay may occur just as with ordinary teeth. There is no way to fill such cavities and severe toothache finally occurs.

Likewise, bacteria in the mouth may cause pericoronitis, an infection around the crown of the tooth. This infection may spread to the cheek, throat, neck with severe pain, stiffness of the jaws, and general bodily illness. An impacted teeth press against other good teeth they injure their roots or push these out of position.

Sometimes a large cyst forms around the crown of an impacted tooth with the destruction of much bone and damage to other teeth in the region.

Which choice is best for you?

1.  If not the least apprehensive or nervous about the procedure, then local by itself may suffice.

2.  If you are a patient who is not overly apprehensive about the procedure, but at the same time you are still not at ease or comfortable with dental procedures, then Nitrous oxide may be appropriate for you.

3.  If you are a patient who experiences anxiety at the thought of oral surgery, you desire more than light relaxation or have not had much dental work, IV sedation is recommended as the best alternative to ensure a positive experience at our office Approximately 80% of patients prefer IV Sedation.

*Regardless of your surgical choice, local anesthesia is always administered prior to surgery. *

PLEASE Follow the instructions for the type of surgery that you selected.

Local Anesthesia (Numbing your mouth)

Local Anesthesia is a series of dental injections which numbs your mouth in preparation for oral surgery. The injections follow the painting of the gums with a topical anesthetic which numbs the tissue so that the discomfort is minimized while local anesthesia is administered.


Nitrous Oxide (Laughing Gas)

The gas is inhaled through the mask that is placed over the nose for the duration of surgery. It makes the patient feel relaxed and takes the edge off any apprehension that may be experienced. *The patient is still aware of the procedure and you are in control of your senses, which means you can both hear and see the procedure being performed.*


IV Sedation (General Anesthesia/Twilight Sleep)

IV sedation is administered intravenously with a combination of medications. Local anesthesia will be given after patient is sedated. The IV is started before the procedure begins and is removed post-operatively. The patient experiences a twilight sleep, you will drift off into a light sleep. After procedure is complete you will wake up with little or no recollection of the surgery.

Why should impacted teeth be removed when they do not cause trouble?

While it is true that not all impacted teeth cause the complications that have been described, no one call tell by an x-ray which ones are going to give difficulty or when. Trouble usually comes unexpectedly and at inconvenient times. Older individuals do not stand the operation for removal as well as younger people, and the operation is more difficult with advancing age. For these reasons, all adults with impacted teeth are advised to have them removed. If a patient with an impacted tooth waits until it causes trouble, he or she will first have to be treated for the infection or other complications before the operation for removal can be done. This means additional loss of time and expense as well as some added risks.

What is it like to have an impacted tooth removed?

Many ordinary teeth can be extracted simply by grasping with forceps and manipulating carefully from the socket. This is, of course, not possible with impacted teeth since they are partially or completely beneath the surface. The removal of an impacted tooth is an operation in every sense of the word. This is not said to frighten the prospective patient, but to give better understanding about certain features regarding the cost, careful preparations, selection of surgeon, and the need for good post-operation care.

The actual removal of the tooth is done in keeping with surgical principles—meticulously sterile instructions, disposable supplies, good light, a dry operative field and gentle handling of the soft tissues and bone. Depending on the difficulty of the procedure, it may last twenty to sixty minutes, although patients are usually in the office for a total of one to two hours. The wound will usually be closed with dissolvable stitches. Careful printed instructions for home care will be furnished.

Are there any complications?

Any operation carries some risk. This is reduced by preoperative appraisal of your physical condition, by careful preparation of instruments and all facilities, and by the skill of the surgeon. The wound remaining after an impacted tooth is quite large and healing may be delayed because the body is unable to fill in with normal tissue as quickly as with a small wound. For this reason, it is not wise for patents who have had this operation to leave on a long trip or be where they could not secure good care. The nerve that runs through your lower jaw may be disturbed at the time the lower teeth are removed. If this occurs it may result in numbness or tingling of the lip, chin, gums, cheeks, and /or tongue with loss of taste. The numbness, tingling and or loss of taste may last from a few weeks to an indefinite period of time. In some cases, it may become permanent. The percentage of this happening is small but important for you to understand and will be discussed at your appointment.

Upper impacted third molars lie against the wall of the maxillary sinus or antrum. The surgeon will use great care to see that no unnecessary injury occurs to this structure, but occasionally the thin wall of bone cracks slightly and blood seeps into the sinus. If this happens the patient may notice a trace of blood in the nose. In a few days this heals normally, usually without complications. All patients about to have impacted removed should understand that adjacent teeth may have been weakened or otherwise injured by the presence of the impacted tooth. This injury may have not been apparent until the impacted tooth is removed. Adjacent teeth must therefore treated gently for the next three to six months after the impacted tooth has been removed.

Due to Coronavirus (COVID-19); We are asking our patients to call our office immediately, if patient or anyone you come in contact with was exposed to or develops symptoms associated with COVID-19.

Thank you for being our patient. We value your trust and loyalty and look forward to welcoming back our patients, neighbors, and friends.



Dr. Slott, Dr. Hambrook and Office Staff