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Impacted Tooth

Definition

An impacted tooth is a tooth that is positioned against another tooth, bone, or soft tissue so that it is unlikely to fully erupt through the gums to reach its normal position in the mouth.

Wisdom Teeth (Third Molars)
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Causes

Impaction typically occurs in the third molars, also called wisdom teeth. Wisdom teeth, which begin to develop around age 9, are most vulnerable to impaction because they are the last teeth to erupt, usually between the late teens and early 20s. By then, the jaw has stopped growing and may be too small to accommodate these four teeth.

An impacted tooth remains embedded in soft gum tissue or bone beyond its normal eruption time. The cause may be overcrowding. Other teeth may also become twisted, tilted, or displaced as the new teeth try to emerge.

Risk Factors

Impacted teeth are very common. Factors that may increase your risk of impacted teeth include:

  • Genetics
  • Poor orthodontic treatment

Symptoms

Some people with impacted teeth have no pain or other symptoms. In those that have symptoms, impacted teeth may cause:

  • Pain or tenderness of the gums or jaw bone
  • Unpleasant taste when biting down
  • Bad breath
  • Redness and swelling of the gums around the impacted tooth
  • Prolonged, unexplained headache or jaw ache
  • Difficulty opening your mouth

Complications of untreated impacted teeth include:

  • A cyst in the soft tissue under the gum line
  • Tooth decay
  • Misalignment of other teeth
  • Gingivitis —inflammation of the gums, which can lead to infection
  • Absorption of bone or adjacent teeth

Diagnosis

Your dentist will ask about your symptoms and medical history. A physical physical exam will be done. Tests may include:

  • A visual examination to look for signs of infection or swelling
  • Dental x-rays to confirm tooth impaction

Treatment

If an impacted tooth causes no pain, inflammation, infection, and does not affect mouth alignment, no treatment may be necessary.

If there are noticeable symptoms, surgery is usually recommended to remove all impacted teeth, preferably while the person is young. This may be done by a dentist under local anesthesia if the tooth is exposed and can be easily removed in one piece. For difficult extractions, your dentist may refer you to an oral surgeon. In these cases, general anesthesia or an IV sedative may be used. Your dentist may recommend following until surgery can be scheduled:

  • Over-the-counter pain relievers to ease pain and swelling
  • Gargling with warm salt water to soothe gums

Prevention

There are no current guidelines to prevent impacted teeth.

Revision Information

  • The American Association of Oral and Maxillofacial Surgeons

    http://www.aaoms.org

  • The American Dental Association

    http://www.mouthhealthy.org

  • Canadian Dental Association

    http://www.cda-adc.ca

  • Canadian Dental Hygienists Association

    http://www.cdha.ca

  • Center for Oral and Maxillofacial Surgery. Exposure and bracketing of an impacted tooth. Center for Oral and Maxillofacial Surgery website. Available at: http://www.cfoams.org/oral%5Fsurgery%5Fmadison/impacted%5Fcanines.html. Accessed October 29, 2013.

  • Impacted tooth. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated August 26, 2013. Accessed October 29, 2013.

  • Wisdom teeth. American Association of Oral and Maxillofacial Surgeons website. Available at: http://www.aaoms.org/conditions-and-treatments/wisdom-teeth. Accessed July 27, 2011.

  • Wisdom teeth. American Dental Association Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/az-topics/w/wisdom-teeth. Accessed October 29, 2013.

  • When to remove wisdom teeth. Academy of General Dentistry Know Your Teeth website. Available at: http://www.agd.org/patient-resources.aspx. Updated January 2012. Accessed October 29, 2013.