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An impacted tooth is a tooth that fails to fully emerge through the gum.

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

Symptoms

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

Signs and tests
Your dentist will look for enlarged tissue over the area where a tooth has not emerged, or has emerged only partially. The impacted tooth may be pressing on adjacent 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.

Diagnosis
Upon visual examination, the dentist may find signs of infection or swelling in the area where the tooth is present or only partially erupted. Dental x rays are necessary to confirm tooth impaction.

Impacted Tooth Complications

  • Recurrent infection of a partially buried tooth
  • Abscess of the tooth/gums
  • Malocclusion of the teeth
  • Chronic discomfort in the mouth
  • Plaque traps

Treatment
The goal of treatment is to relieve irritation of the mouth caused by the impacted tooth. If the impacted tooth is not causing infection or inflammation, or is not affecting the alignment of the other teeth, no treatment may be necessary.

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

Extraction (removal) of the tooth is the usual treatment for an impacted tooth. This often is performed in the dentist's office under local anesthesia. If the tooth is deeply impacted or difficulty with extraction is expected, the dentist may refer the person to an oral surgeon for tooth removal. Antibiotics may be required prior to tooth extraction if the area around the tooth is infected.

A dentist may perform an extraction with forceps and local anesthetic if the tooth is exposed and appears to be easily removable in one piece.Extracting an impacted tooth typically requires cutting through gum tissue to expose the tooth, and may require removing portions of bone to free the tooth. The tooth may have to be removed in pieces to minimize destruction to the surrounding structures. The extraction site may or may not require one or more stitches to help the incision heal.

Prognosis
The prognosis is very good when impacted teeth are removed from young healthy adults without complications. Potential complications include postoperative infection, temporary numbness from nerve irritation, jaw fracture, and jaw joint pain. An additional condition which may develop is called dry socket: when a blood clot does not properly form in the empty tooth socket, or is disturbed by an oral vacuum (such as from drinking through a straw or smoking), the bone beneath the socket is painfully exposed to air and food, and the extraction site heals more slowly.

It is often preferable to have wisdom teeth extracted when a patient is under 30, due to the flexibility of bone, which will allow an easier extraction and better healing. As a person ages, the bone becomes more rigid and complications can develop.


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