In many instances, impacted wisdom teeth do not produce signs and symptoms. In cases when they do, it is primarily attributed to the onset of gum diseases and infection that has set in. Under such circumstances, the following signs and symptoms are experienced:

• Pain in the affected area
• Tender and swollen gums
• Gums may bleed and be painful
• Development of bad breath and unpleasant taste inside the mouth
• Headache
• Swelling around the jaw area

Impacted wisdom teeth can be clinically diagnosed in patients who have partial eruption and the teeth is visible during examination so that the angulation and depth of the impaction can be determined. Such a kind of analysis is also possible if the patients are too young for further eruption of the wisdom tooth. It has been known that, wisdom teeth continues to grow even during adulthood and significantly contribute to the development of periodontal disease [6].

When clinical diagnosis does not provide useful information about the condition, then dental X-ray examination or cone beam CT scan are used for diagnosing the condition of impacted wisdom teeth [7].

In conditions, when the impacted wisdom teeth are causing problem, surgical removal is the best option. Complications resulting from surgical extraction of tooth are rare and therefore it is considered as the best method which is done by the socket-shield technique [8] [9].

Impacted wisdom teeth that do not cause any problems are generally considered as asymptomatic. However, there is no evidence suggesting that such teeth would not be a significant source of problem later in life too. Therefore, keeping this in mind, there have been several controversies surrounding the surgical removal of such impacted teeth. Scientists argue that, the asymptomatic impacted wisdom teeth cannot be disease free and therefore, extraction is the best method to avoid onset of future complications.

The prognosis of the condition gravely depends on the severity of impaction. In cases, when there is complete impaction, there is significant fear of development of cysts or neoplasms in the affected area. Such a type of phenomenon is however uncommon. In individuals with partial impaction, the chances of development of signs and symptoms usually increase with age. Studies have reported that, about 30 to 60% of individuals with impacted wisdom teeth, who were asymptomatic in the past, experienced symptoms of gums disease almost 2 to 4 years after the first examination was carried out [5].

The major cause of wisdom teeth to get impacted is that they do not get enough space to appropriately erupt. In other conditions, the mouth is overcrowded, which does not allow enough space for the third molars to develop at a normal pace. In such situations, the third molars get trapped and thereby become impacted. Impacted wisdom tooth can either be partially impacted, wherein the crown is visible or they are completely impacted, where they do not break out from the gums [2]. There are certain pieces of evidence suggesting a genetic predisposition for development of wisdom teeth impaction [3].

A large scale study carried out in New Zealand revealed that 95.6% had at least one wisdom tooth which had an eruption rate of 15% in the maxilla and 20% in the mandible. In yet another study, which was done on 5000 army recruits, showed 10,767 impacted wisdom teeth.

Wisdom teeth can either be partially or fully impacted. In both the cases, the teeth grow in the following directions:

• It may grow at an angle in the direction of second molar
• It may grow at the back of the mouth
• It my grow in a direction that forms a right angle with the other tooth; giving an appearance as if the wisdom tooth lies within the jaw bone
• Grows straight as any other teeth, but may be trapped inside the jaw bone

In individuals with partially impacted wisdom teeth, the most common reason for tooth removal are development of pericoronitis, or any other infection of the gums [4]. Statistics has revealed that, about 15% of individuals with impacted wisdom teeth suffer from cavities either on the surface of the impacted tooth or in the neighboring second molars.

The occurrence of impacted wisdom teeth cannot be prevented. However, onset of complications can certainly be kept at bay if the condition is promptly treated by either extraction of tooth or local methods to treat gum infections. Maintaining proper dental hygiene can help in preventing the onset of gum cavities and infection [10].

Impacted wisdom teeth are also known as impacted third molars. Impacted wisdom teeth can cause damage to the teeth which are adjacent to it. In many instances however, the wisdom teeth may not cause any problems. Such teeth may be difficult to clean and therefore can be susceptible to tooth decay and onset of gum diseases [1].

• Definition: Impacted wisdom teeth is a condition, wherein the wisdom tooth does not fully erupt due to various factors. Such a type of condition can be a cause of great discomfort for individuals who develop pain and other associated symptoms due to tooth impaction.
• Cause: Various factors that prevent or obstruct the complete eruption of wisdom teeth give rise to impacted wisdom teeth. The major cause is when the mouth gets overcrowded with other teeth, leaving little room for the wisdom teeth to sufficiently grow.
• Symptoms: In many cases, individuals do not experience symptoms. However, when impacted wisdom teeth favors the development of cysts or gum disease, affected individuals suffer from pain, tenderness, swelling along with redness, bad breath and unpleasant taste in mouth.
• Diagnosis: Clinical examination is often enough for diagnosing impacted wisdom teeth. However, when this does not provide useful insight, then dental radiographs and core beam CT scan may also have to be employed.
• Treatment: Treatment of impacted wisdom teeth depends on whether or not the condition is causing any symptoms. In case of development of gum disease or infections, surgical extraction of the teeth is recommended. Treatment of asymptomatic impacted wisdom teeth is controversial, whether or not to be surgically removed.

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