(Unemerged Tooth; Dental Impaction)
DefinitionAn 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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CausesImpaction 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 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 FactorsImpacted teeth are common. Factors that may increase your risk of impacted teeth include:
- Poor orthodontic treatment
SymptomsSome 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
- 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
DiagnosisYou 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
TreatmentIf 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
PreventionThere are no current guidelines to prevent impacted teeth.
The American Association of Oral and Maxillofacial Surgeons
Mouth Healthy—The American Dental Association
Canadian Dental Association
Canadian Dental Hygienists Association
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 September 30, 2014.
Impacted tooth. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 11, 2014. Accessed September 30, 2014.
Wisdom teeth. Mouth Healthy—American Dental Association website. Available at: http://www.mouthhealthy.org/en/az-topics/w/wisdom-teeth. Accessed September 30, 2014.
Wisdom teeth management. American Association of Oral and Maxillofacial Surgeons website. Available at: http://myoms.org/procedures/wisdom-teeth-management. Accessed September 30, 2014.
- Reviewer: Michael Woods, MD
- Review Date: 08/2014
- Update Date: 09/30/2014
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