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A treatment controversy exists about the need for and timing of the removal of disease-free impacted wisdom teeth. Supporters of early removal cite the increasing risks for extraction over time and the costs of monitoring the wisdom teeth. Supporters for retaining wisdom teeth cite the risk and cost of unnecessary surgery.
The most common location of dry socket: in the socket of an extracted mandibular third molar (wisdom tooth). Since alveolar osteitis is not primarily an infection, there is not usually any pyrexia (fever) or cervical lymphadenitis (swollen glands in the neck), and only minimal edema (swelling) and erythema (redness) is present in the soft tissues surrounding the socket.
Impacted wisdom teeth are classified by the direction and depth of impaction, the amount of available space for tooth eruption and the amount of soft tissue or bone that covers them. The classification structure allows clinicians to estimate the probabilities of impaction, infections and complications associated with wisdom teeth removal. [31]
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There is evidence that use of antibiotics before and/or after impacted wisdom tooth extraction reduces the risk of infections by 66%, and lowers incidence of dry socket by one third. For every 19 people who are treated with an antibiotic following impacted wisdom tooth removal, one infection is prevented. [19]
Pericoronitis is inflammation of the soft tissues surrounding the crown of a partially erupted tooth, [1] including the gingiva (gums) and the dental follicle. [2] The soft tissue covering a partially erupted tooth is known as an operculum, an area which can be difficult to access with normal oral hygiene methods.
Most often, the cause of impaction is inadequate arch length and space in which to erupt. That is the total length of the alveolar arch is smaller than the tooth arch (the combined mesiodistal width of each tooth). The wisdom teeth (third molars) are frequently impacted because they are the last teeth to erupt in the oral cavity.
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