Impacted Tooth
What Is
It?
Teeth are impacted when they fail to emerge
through the gums, or emerge only partially,
at the expected time.
Your wisdom teeth, also called third molars,
usually begin to erupt between the ages of
17 and 21. Because they are the last to
emerge in the mouth, wisdom teeth are the
most common teeth to become impacted. This
may happen because a wisdom tooth is turned
to the side, tilted or otherwise positioned
incorrectly in the jaw. Wisdom teeth also
become impacted when there is not enough
room in the jaw or the mouth for them to
emerge.
An impacted tooth can be painless, and you
may not even realize it's there. However,
when an impacted wisdom tooth tries to
erupt, the overlying gum may swell and cause
pain, which may also be felt in nearby teeth
or the ear on that side. A partially erupted
tooth can collect food and other debris,
which can lead to gum swelling and an
infection called pericoronitis. If
untreated, this infection can spread toward
the throat or into the neck. Impacted teeth
also can cause problems if they develop
decay or if they push on the neighboring
molar, which could lead to tooth movement or
decay, as well as changes in the bite (the
way the teeth come together). Impacted teeth
also can cause cysts and other benign
(harmless) jaw tumors. These can lead to
bone destruction. However, this is rare.
Symptoms
Symptoms include:
▪ Swelling of the gum in the back of the
mouth or on the side of the jaw
▪ Difficulty opening the jaw
▪ Bad breath
▪ An unpleasant taste in the mouth
▪ Pain or irritation when you open your
mouth
▪ Pain when chewing or biting
▪ Pain can occur for several days and then
disappear for weeks or months
before returning.
Diagnosis
Your dentist will examine the area and
take X-rays if needed. X-rays can show where
your wisdom teeth are and if they are
impacted.
Expected Duration
Symptoms caused by a problematic tooth
are relieved when the tooth is extracted.
Prevention
There is no way to prevent an impacted
tooth, but careful dental hygiene —
brushing, flossing or the use of water-jet
devices — can reduce the risk of infection.
Treatment
You can sometimes relieve minor
irritation by rinsing with warm salt water
(1/2 teaspoon of salt in 8 ounces of water)
or by taking over-the-counter painkillers.
If the tooth continues to cause pain, is
infected or is interfering with nearby
teeth, the usual treatment is for the tooth
to be extracted. This can sometimes be done
in your dentist's office with a local
anesthetic, depending on how far the tooth
is under the gum. Extracting one tooth can
take 5 to 30 minutes, depending on the
position of the tooth.
People often are referred to an oral and
maxillofacial surgeon to have an impacted
tooth removed. It is not uncommon to have
all the wisdom teeth removed to prevent
problems in the future. This usually is done
in the surgeon's office with sedation and
local anesthesia.
Before the extraction, your dentist or oral
surgeon will talk to you about the procedure
and what type of anesthesia and sedatives he
or she will use. You will not be able to eat
for six hours before surgery and should take
all your medications on schedule. Someone
should drive you to the appointment and take
you home.
After the surgery, your cheeks may swell,
and you will find it difficult to eat some
foods. Follow your dentist's or oral
surgeon's instructions carefully to minimize
problems.
Complications of surgery are rare but do
occur.
If the impacted tooth is not causing
irritation or affecting nearby teeth, you
won't need immediate treatment. However,
your dentist likely will recommend that the
tooth be extracted to avoid problems later.
Although not all impacted teeth lead to
problems, many will. In addition to causing
pain and possibly infection, impacted wisdom
teeth can decay just like teeth that have
emerged through the gum. An impacted wisdom
tooth also can lead to the development of a
follicular (dentigerous) cyst, which can
damage nearby teeth and has the potential to
destroy nearby bone.
Often, it is better to have wisdom teeth
extracted before age 21, sometimes as early
as age 16. The surgery often is less
complicated, and the area, including the
surrounding tissue and bone, heals better
than if they are removed later in life.
When To Call A Professional
Because an impacted tooth can damage
neighboring teeth or distort the bite, call
your dentist if you experience pain in your
molar teeth and your wisdom teeth have not
yet come in. If you visit your dentist
regularly, he or she will keep track of your
wisdom teeth and let you know if you need to
have them extracted. Because routine X-rays
for cavities often don't show the wisdom
teeth, your dentist may take extra X-rays to
check these teeth.
Prognosis
The outlook after surgery is excellent.
Additional Information
American Dental Association
211 East Chicago Ave.
Chicago, IL 60611
Phone: (312) 440-2500
Fax: (312) 440-2800
http://www.ada.org/
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