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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Impacted tooth

Tooth - unemerged; Unemerged tooth; Dental impaction; Unerupted tooth

Last reviewed: February 25, 2014.

An impacted tooth is a tooth that does not break through the gum.

Causes

Teeth start to pass through the gums (emerge) during infancy, and again when the primary (baby teeth are replaced by the permanent teeth.

If a tooth fails to come in or emerges only partially, it is considered to be impacted. This most commonly happens with the wisdom teeth (the third set of molars). They are the last teeth to emerge. They usually come in between the ages of 17 and 21.

An impacted tooth remains stuck in gum tissue or bone for various reasons. The area may be overcrowded so there's no room for the teeth to emerge. For example, the jaw may be too small to fit the wisdom teeth. Teeth may also become twisted, tilted, or displaced as they try to emerge. This results in impacted teeth.

Impacted wisdom teeth are very common. They are often painless and do not cause problems. However, some professionals believe an impacted tooth pushes on the next tooth, which pushes the next tooth. Eventually, this can cause a misalignment of the bite. A partially emerged tooth can trap food, plaque, and other debris in the soft tissue around it, which can lead to inflammation and tenderness of the gums and unpleasant mouth odor. This is called pericoronitis. The retained debris may also lead to the decay on the wisdom tooth or the neighboring tooth.

Symptoms

  • Difficulty opening the mouth (occasionally)
  • Pain or tenderness of the gums (gingiva) or jaw bone
  • Prolonged headache or jaw ache
  • Redness and swelling of the gums around the impacted tooth
  • Swollen lymph nodes of the neck (occasionally)
  • Unpleasant taste when biting down on or near the area
  • Visible gap where a tooth did not emerge

Exams and Tests

Your dentist will look for swollen tissue over the area where a tooth has not emerged, or has only partially emerged. The impacted tooth may be pressing on nearby teeth. The gums around the area may show signs of infection such as redness, drainage, and tenderness. As gums swell over impacted wisdom teeth and then drain and tighten, it may feel like the tooth came in and then went back down again.

Dental x-rays confirm the presence of one or more teeth that have not emerged.

Treatment

No treatment may be needed if the impacted tooth is not causing any problems.

Over-the-counter pain relievers may help if the impacted tooth causes discomfort. Warm salt water (one-half teaspoon of salt in one cup of water) or over-the-counter mouthwashes may be soothing to the gums.

Removal of the tooth (extraction) is the usual treatment for an impacted tooth. This is done in the dentist's office. Most often, it will be done by an oral surgeon. Antibiotics may be prescribed before the extraction if the tooth is infected.

Outlook (Prognosis)

Impacted teeth may cause no problems for some people and may not need treatment. Treatment is usually successful when it does cause symptoms.

Wisdom teeth removed before age 20 often have better results. This is because the roots are not fully developed. This allows for an easier removal and better healing. As a person ages, the roots become longer and curved. Bone becomes more rigid and complications can develop.

Possible Complications

Complications of an impacted tooth include:

When to Contact a Medical Professional

Call your dentist if you have an unemerged tooth (or partially emerged tooth) and you have pain in the gums or other symptoms.

References

  1. Buttaravoli P, Leffler SM, eds. Dental pain, pericoronitis. Minor Emergencies. 3rd ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 46.

Review Date: 2/25/2014.

Reviewed by: Ilona Fotek, DMD, MS, Palm Beach Prosthodontics Dental Associates, West Palm Beach, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Surgical removal versus retention for the management of asymptomatic impacted wisdom teethSurgical removal versus retention for the management of asymptomatic impacted wisdom teeth
    Wisdom teeth, or third molars, generally erupt into the mouth between the ages of 17 to 24 years. These are normally the last teeth to erupt and mostly into a position closely behind the last standing teeth (second molars). Space for these teeth to erupt can be limited and more than other teeth, wisdom teeth often fail to erupt or erupt only partially. Failure of the third molars to fully erupt is often due to impaction of the wisdom teeth against the second molars (teeth directly in front of the wisdom teeth). This occurs when the second molars are blocking the path of eruption of the third molar teeth and act as a physical barrier preventing further eruption. An impacted wisdom tooth is called asymptomatic if the patient does not experience signs or symptoms of pain or discomfort associated with this tooth.
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