Table of contents
What is an Impacted Tooth?
When a tooth erupts correctly, the entire tooth will emerge from the gums, making it fully visible. If it is impacted, it fails to emerge fully.
Instead, it can try to erupt sideways or at an abnormal angle. Adjacent teeth can block its eruption. Most often, wisdom teeth are impacted, and the standard treatment is to have them removed.
When cuspids (also known as canines) are affected, a different treatment approach may be necessary, especially when treating children and young adults. These teeth tend to be impacted in the upper palate, the roof of the mouth, or near adjacent teeth.
Canine teeth help guide biting and chewing, so, where possible, impacted cuspid surgery is used to expose these teeth so they can be repositioned and function normally.
What Can Cause an Impacted Tooth?
Several situations may result in teeth becoming impacted, including:
- A lack of space in the jawbone, which can occur if you have a small jaw or additional teeth (supernumerary teeth).
- Overcrowding so that teeth cannot erupt normally.
- Rotated or crooked teeth that are coming through sideways.
- Baby teeth that have failed to fall out in time.
Symptoms of an Impacted Tooth
Symptoms that a tooth may be impacted include:
- Swollen, red, and bleeding gums.
- Bad breath or an unpleasant taste.
- Part of the tooth may be showing, where it has partially erupted.
- Jaw pain.
- Facial swelling.
- Difficulty opening your mouth.
- Earache or headaches.
- Swollen lymph nodes in your neck.
Types of Impaction
There are three main types of impacted teeth outlined below.
- Soft Tissue Impaction
With this impaction, the tooth has erupted through the jawbone but has not yet erupted through the gums.
- Partial Bony Impaction
The tooth that has partially erupted through the jawbone but remains completely stuck underneath the gum.
- Full Bony Impaction
None of the tooth has erupted through the jawbone or gum.
Does an Impacted Tooth Require Treatment?
Not every tooth may require immediate treatment. Some do not cause any health issues, but other times they can cause problems. When you visit our dental practice, we can assess the tooth to determine if oral surgery is needed. This is dependent on factors including:
- Whether the tooth is causing pain or swelling.
- The location of the tooth, as some may be near nerves in the lower jaw or are impacted in the wrong parts of the mouth, such as in the upper palate.
- Whether the tooth is affecting your oral hygiene routine and making it tricky to brush and floss.
- Age, as some people with impacted teeth still have primary or baby teeth.
Potential complications of leaving impacted teeth untreated may include:
- Tooth decay.
- Gum disease.
- Dental abscess.
- Malocclusion or a poor bite.
- Gum inflammation around the back teeth (pericoronitis).
- Nerve damage in the lower jaw.
- Dental cysts that can develop under the gums.
Diagnosing an Impacted Tooth
A dental exam can help us identify if you have an impacted tooth. Digital dental X-rays enable us to assess teeth and tooth roots that are hidden beneath the jawbone and gums, and to plan a suitable treatment.
If more complex surgery is needed, we may recommend taking a panoramic digital dental x-ray, which shows both the upper and lower jaws and teeth in one complete image. A cone beam CT scan, which provides a 3D image of the teeth and jaws, may also be required.
Treatment Options for Impacted Teeth
Several treatment approaches are available, depending on the location of the tooth, your symptoms, and situation. These approaches include:
Monitor the Tooth
If an impacted tooth is not causing any symptoms, we may suggest monitoring it closely for any changes during your regular dental checkups and cleanings to ensure it remains healthy.
Remove the Impacted Tooth
An impacted tooth that is causing discomfort or affecting dental health will need to be removed, including cuspid or canine teeth. This may be the case if an adult has an impacted canine tooth, which is harder to treat and reposition correctly.
Usually, surgery involves making a small incision into the gum and the underlying bone to expose the tooth. Sectioning it into smaller pieces makes it easier to remove more comfortably.
We can use anesthesia or sedation dentistry to provide additional comfort.
Tooth Exposure Surgery
Sometimes, we may recommend surgical exposure of an impacted tooth. This treatment is most commonly used for children and teenagers, where impacted canine tooth surgery is performed to help the tooth erupt correctly.
After the impacted tooth is exposed, orthodontic treatment may be required to provide sufficient space for the canine and to reposition it in the correct location. Sometimes an orthodontic bracket is attached to the exposed canine after impacted cuspid surgery. The bracket will help guide the exposed canine into the right location.
Another option is to expose the impacted canine tooth before attaching a bracket and orthodontic wire. The gum is then replaced over the tooth, so only the orthodontic wire is visible. This remains visible as the canine tooth is guided into its correct position.
After the canine is repositioned, minor gum recontouring may be necessary to achieve a more aesthetically pleasing appearance.
Recovery after Tooth Exposure Surgery
After a tooth exposure surgery, it’s normal to experience some minor discomfort. This is controllable with over-the-counter painkillers, or we can prescribe something stronger. Any discomfort should disappear after the first few days.
Minor swelling around the surgery site is completely normal. We recommend using ice packs wrapped in a towel and held against the face to reduce swelling.
It’s best to avoid hard, crunchy foods or anything with seeds or nuts, as the pieces could become stuck around the exposed tooth and irritate the gum.
NYC Dentistry Center6 E 45th Street, 8th Floor, Suite 2
New York, NY 10017
(212) 810-9264