In dental clinical practice, the condition of impacted wisdom teeth is one of the most common issues, causing many uncomfortable complications for patients. Mastering the technical procedure and professional indications is a key factor in ensuring safety and treatment effectiveness.

Overview of impacted wisdom teeth

Wisdom teeth are the third molars, usually erupting in adulthood. Due to the narrowing of the dental arch during evolution, these teeth often lack sufficient space to grow straight, leading to impaction or embedding. When wisdom teeth are impacted, they can impinge on the adjacent second molar (tooth No. 7), causing pain, swelling, or creating cavities and pericoronitis.

Indications and contraindications for surgery

Based on the professional guidelines of the Ministry of Health, surgical intervention for impacted wisdom teeth must comply with the following conditions:

1. Surgical indications: Surgery is indicated when impacted wisdom teeth cause complications such as pain, recurrent infection, affecting adjacent teeth, or hindering other orthodontic treatment plans.

2. Contraindications:

• Systemic: Patients suffering from systemic diseases that do not allow surgery, such as severe coagulation disorders or uncontrolled acute pathologies.

• Local: Patients in the acute infection stage in the oral cavity. In this case, it is necessary to treat the acute episode before proceeding with intervention.

Technical implementation procedure

According to the “Technical Guidelines on Odonto-Stomatology”, the procedure for extracting impacted wisdom teeth usually lasts from 45 to 60 minutes and is performed through standard medical steps:

• Anesthesia: Perform local infiltration or block anesthesia to ensure the patient is pain-free throughout the process.

• Performing the technique: The doctor performs the separation of the periodontal ligament, then bone removal to expose the tooth and create a leverage point. For complex impaction cases, sectioning the tooth crown or splitting roots is required before using elevators to remove the tooth from the socket.

• Control and hemostasis: After removing all tooth and root fragments, the doctor will check the socket, reshape if necessary, and perform hemostasis.

Monitoring and handling complications

Although a routine procedure, surgery for impacted wisdom teeth still carries risks requiring caution. Complications that may occur during the process include anaphylactic shock, local anesthetic toxicity, local bleeding, or trauma to adjacent tissues (such as adjacent teeth or nerves).

After surgery, patients need to be instructed on local care and use antibiotics and analgesics as prescribed by the doctor. If signs such as prolonged bleeding or infection appear, the patient must be re-examined immediately for timely handling.

Conclusion

The management of impacted wisdom teeth requires technical precision and strict adherence to professional guidelines. This not only helps eliminate pain but also protects the patient’s overall oral health. Medical staff need to fully implement record checks and surgical safety checklists before proceeding to minimize errors.

Source of cited information: Ministry of Health (2025), “Technical Guidelines on Odonto-Stomatology – Volume 1”, issued with Decision No. 3634/QĐ-BYT dated May 24, 2025.

MSc. Dr. Cao Thanh Hoa – Deputy Director of the Center for Support & Continuing Education