• Impacted Tooth

    (Unemerged Tooth; Dental Impaction)

    Definition

    An impacted tooth is a tooth that is positioned against another tooth, bone, or soft tissue. The position of the tooth makes it 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

    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.
    Impaction typically occurs in the third molars, also called the wisdom teeth. Wisdom teeth, which begin to develop around age 9, are most likely to impact 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 have room for these 4 teeth.

    Risk Factors

    Impacted teeth are common. Factors that may increase your risk of impacted teeth include:
    • Genetics
    • Lack of orthodontic treatment

    Symptoms

    Some people with impacted teeth have no pain or other symptoms. In those who have symptoms, impacted teeth may cause:
    • Redness and swelling of the gums around the impacted tooth
    • Pain or tenderness of the gums or jaw bone
    • Prolonged, unexplained headache or jaw ache
    • Difficulty opening your mouth
    • Unpleasant taste when biting down
    • Bad breath
    Complications of untreated impacted teeth include:
    • A cyst in the soft tissue under the gum line
    • Tooth decay
    • Poor alignment of other teeth
    • Swelling 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 dental exam will be done.
    Dental x-rays will be done 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 needed.
    If there are symptoms, surgery is 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 removed in 1 piece. For difficult extractions, a referral may be made to an oral surgeon. In these cases, general anesthesia or an IV sedative may be used.
    Until surgery is scheduled, the following may be advised:
    • Over the counter pain relievers to ease pain and swelling
    • Gargling with warm salt water to soothe the gums

    Prevention

    There are no current guidelines to prevent impacted teeth.

    RESOURCES

    American Association of Oral and Maxillofacial Surgeons http://myoms.org

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

    CANADIAN RESOURCES

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

    Dental Hygiene Canada http://www.dentalhygienecanada.ca

    References

    Dental practice parameters: impacted/unerupted tooth. American Dental Association website. Available at: http://www.ada.org/en/science-research/dental-practice-parameters/impacted-unerupted-tooth. Revised 1997. Accessed August 22, 2017.

    Shah S, Kulkarni G. Guiding uninterupted teeth into occlusion: case report. J Can Dent Assoc. 2010;76:a147. Available at: http://www.jcda.ca/article/a147. Accessed August 22, 2017.

    Wisdom teeth. Mouth Healthy—American Dental Association website. Available at: http://www.mouthhealthy.org/en/az-topics/w/wisdom-teeth. Accessed August 22, 2017.

    Wisdom teeth management. American Association of Oral and Maxillofacial Surgeons website. Available at: http://myoms.org/procedures/wisdom-teeth-management. Accessed August 22, 2017.

    Revision Information

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