Impacted and Wisdom Tooth Removal Consent

An impacted tooth has not come through fully and is held by bone, gum, or a neighboring tooth. Removing it usually means lifting the gum, taking away some of the bone around the tooth, and often sectioning the tooth so it can be removed in pieces. Stitches are usually placed.

This is a different procedure from removing a tooth that is fully through the gum, which is covered by the practice's Dental Extraction Consent.

• Numbness, tingling, or altered feeling of the lip, chin, tongue, or gum, from bruising or injury to the nerves that run close to lower wisdom teeth. This is usually temporary and resolves over weeks to months; it is uncommonly permanent.
• Altered or reduced taste on the side of the tongue.
• Dry socket — loss of the healing clot, causing severe pain typically three to five days afterward and requiring dressing of the socket.
• Pain, swelling, bruising, bleeding, and limited mouth opening, usually worst for two to three days.
• Infection of the socket or surrounding tissue, sometimes needing antibiotics or further treatment.
• Opening into the sinus when an upper tooth is removed, which may need closure and sinus precautions.
• Damage to a neighboring tooth, filling, crown, or bridge; loosening of a neighboring tooth.
• Fracture of the jaw — rare, and more likely with deeply buried teeth in older patients.
• A small root fragment may be deliberately left in place if removing it would put a nerve or the sinus at unacceptable risk.
• Bruising or stiffness of the jaw joint, and soreness at the corners of the mouth.

• Leaving the tooth and monitoring it with periodic examination and imaging, coronectomy where the nerve risk is high and the tooth is otherwise suitable, treating the symptoms only, referral, or no treatment.

• An impacted tooth can cause repeated infection, decay of the tooth in front, gum disease behind the second molar, cyst formation, bone loss, pain, and crowding. Removing it later is often harder and healing slower.