• Impacted Tooth

    (Unemerged Tooth; Dental Impaction)

    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)
    si55551348 97870 1 wisdom teeth
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Impaction typically occurs in the third molars, also called the 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 4 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 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 who 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
    • Inflammation of the gums, which can lead to infection—gingivitis
    • Absorption of bone or adjacent teeth

    Diagnosis

    You will be asked about your symptoms and medical history. A 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, or 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.

    RESOURCES

    The American Association of Oral and Maxillofacial Surgeons http://www.aaoms.org

    Mouth Healthy—The American Dental Association http://www.mouthhealthy.org

    CANADIAN RESOURCES

    Canadian Dental Association http://www.cda-adc.ca

    Canadian Dental Hygienists Association http://www.cdha.ca

    References

    Impacted tooth. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 11, 2014. Accessed September 30, 2014.

    Wisdom teeth. American Dental Association Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/az-topics/w/wisdom-teeth. Accessed August 10, 2015.

    Wisdom teeth management. American Association of Oral and Maxillofacial Surgeons website. Available at: http://myoms.org/procedures/wisdom-teeth-management. Accessed August 10, 2015.

    Revision Information

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