What is an Impacted Tooth?

When the growth of a tooth is impaired due to either a blockage or abnormal formation, the tooth is considered to be impacted. If left untreated, an impacted tooth may cause damage to surrounding teeth, cause pain, or result in further dental problems. Treatment for this condition generally involves the surgical extraction of the affected tooth.

Tooth impaction occurs when there is either an overcrowding of teeth or insufficient space within the mouth for a tooth to emerge. It has been asserted that genetics may play a role in the development of impactions. Individuals may inherit either a small jaw or large teeth or a combination of the two, leading to insufficient space for normal dental development.

In most cases, impaction is a condition that involves the emergence of one’s wisdom teeth. Positioned at the very back of the mouth, wisdom teeth are the last adult, or permanent, teeth to emerge. Most individuals have four wisdom teeth that develop, with two positioned on top and two on bottom.

An impacted wisdom tooth may grow in a variety of ways that hinder its ability to emerge properly. The tooth may grow at an angle toward a nearby tooth or perpendicular to surrounding teeth, in which instance the tooth essentially lies down on the jawbone. In other cases, the tooth may grow perfectly straight but is unable to emerge through the gum, remaining trapped just below the gum's surface.

Individuals with an impacted tooth may remain asymptomatic, meaning they experience no symptoms at all. Others, whose impacted teeth damage surrounding teeth or become infected, may experience a variety of symptoms. Signs indicative of an impacted tooth include pain and a swelling, tenderness, or bleeding of the gum. Individuals who develop persistent headaches, swelling of the jaw, or an unpleasant taste in their mouth accompanied by bad breath may have an impacted tooth. A worsening of any of these symptoms should prompt immediate medical attention to prevent a worsening of symptoms or complications.

An impacted tooth may be diagnosed by either a dentist or oral surgeon. During a preliminary evaluation, an individual may be asked to recount his or her symptoms and their initial onset. A complete medical history may be taken before an initial examination is performed. Following an examination of the affected area, additional X-rays may be taken to further assess the condition of the affected area, reveal signs of damage, and evaluate the position of the impacted tooth.

Regardless of whether or not the individual may be experiencing symptoms, the surgical extraction of a tooth that is impacted may be recommended to prevent future problems. An asymptomatic tooth may be susceptible to dental problems, such as decay and infection. In some cases, a wait-and-watch approach may be taken with an asymptomatic tooth, with extraction conducted at the first sign of a problem.

Individuals who are symptomatic may have the impacted tooth surgically extracted. Conducted under local or sedation anesthesia, an extraction procedure is usually conducted on an outpatient basis. The extraction of the affected tooth is conducted through an incision in the gum. Once the incision is made, any blockage, such as bone, is removed to allow for the excision of the tooth. After the tooth is removed, sutures are taken to close the wound and gauze is placed in the vacant space.

Following the procedure, individuals may be instructed on how to care for the wound at home and manage any post-operative discomfort. Over-the-counter non-steroidal anti-inflammatory medications (NSAIDs) may be administered to alleviate initial pain and inflammation. Complications that may occur following surgery might include the development of dry socket and infection. If a tooth is left impacted, serious complications may develop, including the formation of cysts, decay of the impacted tooth, and gum disease.