The removal of wisdom teeth is the most frequently performed surgery, followed by the removal of canines.
An ectopic (displaced) tooth either fails to surface, or never contacts the occlusal plane after root formation.

What are the causes of tooth retention?

Lack of space is the leading cause of why teeth remain retained. Wisdom teeth emerging last are the ones most affected.
Adhesiolysis, tumors, infections, and post-traumatic conditions may represent impediments which prevent teeth from naturally emerging.

Why should an ectopic tooth be removed?

  • Because of lack of space, despite of orthodontic tooth regulation measures (mostly with retained canines).
  • Because of a recurrent mucosal inflammation in the area of the retained tooth (pericoronitis of the wisdom tooth).
  • When a displaced tooth is the probable origin of radiating jaw pain.
  • When natural mastication is counteracted by misaligned wisdom teeth.
  • When a cyst or tumor have formed, emanating from an ectopic tooth.
  • When radiographic discovery indicates that an ectopic wisdom tooth is in the process of damaging a neighboring structure by caries or root resorption (breakdown of the adjacent root).
  • In case of shifting teeth (a wisdom tooth could have a devastating effect on an future orthodontic treatment).
  • When at a later point displaced teeth could cause pressure points in a denture.

How does a surgical removal of a tooth work?

Displaced teeth are removed under local anesthesia. As with any surgery, pain (except for a feeling of pressure) will not be felt during the procedure. The mucosa is withdrawn and the tooth is exposed by means of a special drill. When possible, the entire tooth is removed - if not, it has to be split and extracted in pieces.

What about complications?

The following complications are possible:

  • Bleeding after the injection has worn off (or at a later point). With heavy bleeding a re-opening, cleansing of the wound, and stitching, may be required.
  • Swelling may continue until the third day after surgery. After the removal of retained wisdom teeth, an increased difficulty in opening of the mouth may be felt (lockjaw).
  • Breaking of delicate and thin root tips. They are either removed or left, depending on the diagnosis.
  • Damage to neighboring teeth.
  • A part of the tooth may slip off, or bone fragments may lodge themselves into the adjacent soft tissues or the maxillary sinus (frequently leading to a sinus infection).
  • Very rarely can the removal of retained canines cause damage to the nerves in the upper jaw (symptoms on the outside: dysesthesia of the lip, cheek, nose / on the inside: numbness and lack taste in the mouth).
  • After the removal of retained wisdom teeth, damage to the mandibular nerve in the lower jaw may occur. This usually results in temporary, rarely permanent, loss of sensation in teeth, lower lip, and the chin on the applicable side.
  • Damage to the nerve of the tongue may take place, resulting in numbness and a taste disturbance localized on the frontal area of the tongue.
  • Extremely rare: mandibular fracture.
  • Extremely rare: bone infection in the succeeding years, especially with a pre existing condition.

After Surgery