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Mid-Hudson Oral and Maxillofacia Practice, PC | Types of Wisdom Tooth Impactions in Kingston

                  Mid-Hudson Oral and Maxillofacial, PC

117 Marys Avenue | Suite # 104 | Kingston, NY 12401    


                                                                                             (845) 340-1962

Types of Wisdom Tooth Impactions



When a wisdom tooth erupts into the oral cavity it’s said to have erupted. Impaction is where the third molars (wisdom teeth) erupt in an unusual position. Four types of impaction situations exist; in varied degrees. Some of them require surgical intervention by a  trained oral surgeon.

 Many dentists and physicians assume that impacted wisdom teeth automatically need surgical extraction, this is not always necessary. Our prctice specializes in the removal of wisdom teeth in Kingston, NY.  Every patient must be evaluated individually. Thus, the importance of a thorough consultation, including clinical examination with panoramic x-ray review, is emphasized in our office.


There have been many systems used to classify wisdom tooth impactions based on bone depth and angulation. For the sake of simplicity a brief description follows: 


Vertical Impaction    

These molars ocassionally require surgical intervention. These teeth have a relatively normal orientation. There is a strong likelihood  that, over time, they will erupt and assume a normal position in the oral cavity.

If a vertically impacted wisdom tooth does need removing, it’s because it’s pushing against the underside of the molar in front or the bones at the back of the mouth. These are difficult to remove and often result in damage to the surrounding teeth and bone areas. It’s unusual for a vertical impaction to be clinically significant.

Vertically impacted wisdom teeth can normally be extracted by your oral surgeon using a local anesthetic. IV sedation would only be required in the case of an extremely nervous patient. 


Distal Impaction

 A distally(backward facing") impaction is the least commonly found type of impaction. It’s the complete opposite, as far as orientation is concerned, of the mesial impaction The tooth is angled towards the back of the mouth. It doesn’t have a higher chance of needing a wisdom tooth removal. It depends on how dramatic the angle is.

If it’s almost pointing towards 0 degrees, it will erupt as normal but will always have a slight incline. It will fit in the mouth and dentists will normally give it a year or two before they make a decision on whether they need to remove it.
It’s usually up to the Oral and Maxillofacial Surgeon as to whether the tooth needs extraction.


Horizontal Impaction 

 The horizontal impaction is the most challenging kind of impaction to have. It’s pointing entirely away from the gingival(gum)surface and

towards the molar in front of it. . It’s completely horizontal and is running parallel to the jawbone. It often needs removal or it can start to damage the adjacent teeth.

The challenges presented by this type of impaction are  best handled by a highly trained Oral and Maxillofacial Surgeon. It takes a lot of skill to complete this type of wisdom tooth extraction without complications i.e. trauma to the  surrounding area.

This type of impaction may require  having some bone removal, general anesthetic or IV sedation is generally recommended. The patient should also be prescribed painkillers and a thorough after care plan, as always, to decrease discomfort and possible post-surgery complications.

Make sure you always use an experienced Oral and Maxillofacial Surgeon like Dr. Matthew Hilmi for this kind of surgery to minimize the damage caused to the surrounding area.

If wisdom tooth surgery has been recommended by your general dentist, you must be thoroughly informed of what will happen during the procedure. A complete explanation of post-surgical care should also be part of your overall treatment plan.  Please ask questions. Second opinions are not uncommon. 


Mesial Impaction

The mesial impaction is the most common type of impaction. It’s where the wisdom tooth is angled towards the front of the mouth. It impinges upon the space of the molar in front of it. The angulation of the mesial impaction determines whether it becomes a problem.

It commonly leads to a partial eruption where only part of the tooth is visible beyond the gingival (gums). In some clinical cases, observation is sufficient. Eventual eruption is possible. General dentists may keep a watchful eye on these teeth or refer to have a surgeon remove them.



Kingston Oral Surgeon | Types of Wisdom Tooth Impactions. Matthew Hilmi is a Kingston Oral Surgeon.


Oral and Maxillofacial Surgeons treat a lot more than  wisdom teeth.