Impacted teeth are teeth that don’t emerge from inside the gums. In infancy, the primary teeth break through the gums, a process that occurs again when the primary teeth fall out and the secondary, or permanent, teeth replace them. If a tooth doesn’t emerge fully through the gums, or if it remains entirely beneath the gums, the tooth is impacted. While the wisdom teeth, or third molars, are the teeth that most frequently become impacted, any tooth can suffer from impaction, and impaction can occur for a variety of reasons. When wisdom teeth are impacted, this often happens because the mouth is already crowded with teeth; the third molars are the last permanent teeth to emerge, usually in late adolescence or early adulthood, and by that point, there isn’t enough room for them. This may leave them stuck within the jaw, or it may cause them to grow in at odd angles, twisting or angling as they attempt to erupt and become impacted. In some cases, impacted wisdom teeth don’t cause any pain or issues and may not require immediate treatment.
Sometimes, however, a partially impacted tooth might press into the adjacent teeth, affecting the alignment of the bite, and partly emerged teeth are also more susceptible to trapped bacteria and debris. This accumulated debris can cause tooth decay, gum inflammation, and even bone loss. Your dentist can evaluate your impacted tooth or teeth to determine whether treatment is urgent or not. While some impacted teeth cause pain, in some cases, a fully impacted tooth won’t present any symptoms, and your dentist may choose to monitor the tooth with periodic x-rays to assure that this remains true and to provide treatment if things change. Partly impacted teeth are more likely to present symptoms, which can include pain and tenderness in the jaw or gums, a headache, swelling and redness in localized areas of the gums, a swollen neck or swollen lymph nodes, and bad breath or a bad taste in the mouth, especially in the area of the impacted tooth.
If you have an impacted tooth that remains symptom-free, it may not be necessary to treat the issue, though your dentist may recommend extraction if your wisdom teeth pose the risk of future complications. If your impacted tooth is closer to the front of your mouth, your dentist may refer you to an oral surgeon and an orthodontist, who will expose the tooth and use braces or other orthodontia to move the tooth into place. The most common treatment for an impacted wisdom tooth is extraction of the tooth, which your dentist may recommend if the wisdom teeth are causing symptoms or if their position indicates that they will cause symptoms down the road. Earlier extraction is often recommended in part because the wisdom teeth’s roots continue to grow and more complex as people age, making them far more difficult to extract when the patient is older. If you have one impacted tooth that’s causing issues, it’s likely that your oral surgeon will recommend extracting both of the wisdom teeth in that row, if not all four wisdom teeth, to ensure that the bite remains aligned and to remove the risk of future issues. Non-prescription pain medication can help relieve the discomfort of an impacted tooth, and rinsing with warm salt water can help soothe irritated gums. If the impacted tooth is infected, your dentist may prescribe a round of antibiotics to clear infection before extracting the tooth.
