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) 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.