Impacted tooth surgery is the surgical removal of teeth that remain under the jawbone or gum and have not been able to erupt into the mouth. It is planned according to the position of the tooth and its closeness to neighboring teeth and nerves; for this reason the same method is not used for every patient. Surgical tooth extraction, on the other hand, is an extraction performed for teeth that cannot be removed with a normal extraction, by opening the gum and, when needed, working on the bone.
What an impacted tooth is and when surgical intervention is needed
An impacted tooth is a tooth that has not been able to erupt into the mouth when it should and has stayed within the bone or gum. It is most often seen in the lower and upper wisdom teeth, but other teeth such as canines can also stay impacted.
Not every impacted tooth needs to be removed. A dentist may recommend surgical intervention in these situations:
- If it presses on or damages the neighboring tooth
- If it causes recurrent gum inflammation or swelling
- If there is a suspicion of a cyst developing around it
- If space needs to be made for orthodontic treatment
- If it blocks a prosthesis or implant plan
Evaluation before the operation: examination, panoramic X-ray and 3D tomography
Before the operation, the location and direction of the tooth and its relationship with surrounding tissues are determined with a clinical examination and imaging. This stage is the foundation of the surgical plan.
In the clinical examination, mouth opening, gum condition and possible signs of infection are checked. A panoramic X-ray shows the general position of the tooth. In cases where the tooth is close to a nerve, the sinus or neighboring roots, 3D jaw and tooth tomography gives three-dimensional and more detailed information. The medications you use and your general health condition should also be reported to the dentist.
Surgical techniques: flap, bone trimming and sectioned extraction
When an impacted tooth is removed, a gum flap is generally opened, the bone is shaped if needed, and the tooth is removed whole or divided into pieces. The position of the tooth decides which technique will be used.
- Opening a flap: A small incision is made in the gum to reach the area where the tooth is.
- Bone trimming: The bone covering the tooth is removed as much as needed to reach the tooth.
- Sectioned extraction: The tooth is divided in a way that does the least harm to surrounding tissues and is removed in pieces.
At the end of the procedure, the area is cleaned and the gum is closed with stitches.
Anesthesia options, sedation and the surgical process
Impacted tooth operations are mostly done with local anesthesia; a sedation option can also be considered for patients with high anxiety. The choice is made together with the dentist according to the difficulty level of the tooth and your preference.
With local anesthesia, the area is numbed and during the procedure you may feel only touch and pressure. Sedation helps you calm down and get through the procedure more at ease. You can get information about dental treatment under sedation from our clinic.
Nerve, neighboring tooth and sinus risks; preventing complications
The main structures watched in impacted tooth surgery are the nerve in the lower jaw, the roots of neighboring teeth and the sinus in the upper jaw. The position of these structures is determined in advance with imaging and the surgery is planned accordingly.
To reduce the likelihood of complications, it is important to use the medications recommended by the dentist, follow the post-operative instructions and attend check-ups. As with every surgical intervention, swelling, bruising or temporary changes in sensation may be seen; these should be explained to you in advance by your dentist.
Aftercare: dressing, medication and diet
The basis of aftercare is protecting the area, using the medications prescribed by the dentist regularly and eating soft, warm foods. The dentist decides whether antibiotics and painkillers are needed; do not choose medication on your own.
- Use the gauze given to stop bleeding as recommended.
- Avoid hot, hard and spicy foods in the first days.
- Do not poke at the area so as not to dislodge the clot, and stay away from strong rinsing and drinking with a straw.
- Apply a cold compress as the dentist recommends to reduce swelling.
- If you smoke, consider taking a break since it negatively affects healing.
For dietary recommendations, you can look at our article how should one eat after a tooth extraction.
The healing process and common problems: swelling, infection, dry socket
Healing varies from person to person and according to the difficulty of the procedure; swelling and mild discomfort are expected in the first days. Throughout the process, you observe the area recovering little by little.
Contact your dentist in these situations:
- If swelling increases instead of decreasing
- If there is fever or a bad smell and taste
- If pain gets worse after a few days despite medication
- If bleeding does not stop
You can get information about alveolitis (dry socket), which occurs when the clot is lost after an extraction, on our page inflammation after tooth extraction (alveolitis).
Which surgical approach is preferred for whom
The surgical approach is determined according to the depth of the tooth, its root structure and the patient’s general condition. While a more limited intervention may be enough for teeth that are near the surface and simply positioned, deep teeth close to a nerve require detailed planning.
In difficult cases, an evaluation together with a dentist who works in the field of oral, facial and jaw surgery may be appropriate. You can read what this field covers in our article what oral, facial and jaw surgery looks at.
Appointment, preparation and contact in an emergency
To book an appointment, it is enough to contact our clinic; at the first examination your situation is evaluated with an X-ray and, if needed, tomography. Avrupadent’s Çiğli, Balçova, Narlıdere, Buca and Gaziemir branches serve patients in İzmir.
- Tell the dentist about the medications you use and any chronic conditions you have.
- Bring your existing X-ray or tomography images, if you have any.
- On the day of the operation, eat according to the dentist’s guidance and consider bringing a companion with you.
If you experience something unexpected after the operation, contact our clinic as soon as possible.
Frequently asked questions
How long does impacted tooth surgery take?
The duration varies with the position of the tooth, its depth and the structure of its root. Your dentist shares an estimated duration for you after the examination and imaging.
Is impacted tooth extraction painful, and which anesthesia is used?
The procedure is mostly done with local anesthesia; because the area is numbed, only pressure and touch may be felt during the procedure. A sedation option can be considered for anxious patients. After the procedure, discomfort is kept under control with the painkiller recommended by the dentist.
When can I eat normally after impacted tooth extraction?
In the first days soft and warm foods are preferred; hardness of food and chewing ease gradually return to normal depending on healing. Your dentist will tell you the time to return to normal eating at the check-up examination.
What is done if the impacted tooth is close to the nerve?
First, the tooth’s relationship with the nerve is examined in detail with 3D tomography. Accordingly, bone intervention is kept limited or a more careful technique such as removing the tooth in pieces is planned.
Which tests are needed for impacted tooth surgery?
A clinical examination and a panoramic X-ray are generally the basic steps. If the tooth’s relationship with the nerve, sinus or neighboring teeth is not clear, 3D tomography is requested; depending on your general health, the dentist may request additional tests.
If you would like an evaluation for your impacted tooth complaint or your need for surgical tooth extraction, you can set up an appointment through our contact page.
