Impacted Teeth, What are impacted teeth?, What can happen when a tooth is impacted?, How are impacted teeth diagnosed and treated?, Resources
What Can Happen When a Tooth Is Impacted?
Sometimes impacted teeth cause no pain or visible problem, whereas other times they can lead to tooth decay, infection, and gum disease. Normally, partially impacted wisdom teeth cause more health problems than fully impacted teeth. When a tooth partially emerges from the gum, it creates a tiny opening between the gum and the tooth that cannot be cleaned out through brushing or flossing. Bacteria can then enter this space, reproduce, and cause an infection that dentists call pericoronitis, which causes the gum to become tender and swell. The condition can be very painful and also can cause bad breath and a bad taste in the mouth. Pericoronitis is usually treated with antibiotics to kill the bacteria causing the infection, but the disease may return repeatedly if the partially impacted tooth remains in place.
How Are Impacted Teeth Diagnosed and Treated?
A partially impacted tooth is obvious to the dentist on examination. The dentist must then determine whether the tooth is in the process of emerging normally or if it is stuck in position and impacted. A dental x-ray that shows what is happening below the gum line may help the dentist decide whether the tooth is impacted. An x-ray is the only way to confirm the presence of a fully impacted tooth, since in some people wisdom teeth never develop in the jaw. Most dentists take x-rays on a regular basis to help detect tiny cavities and other dental abnormalities. These x-rays are safe and expose people to a very low level of radiation, although special precautions must be taken with women who are or might be pregnant.
The treatment for an impacted tooth is extraction, which is performed by either a dentist or an oral surgeon. An oral surgeon is a person who has graduated from dental school and then had a minimum of four years of hospital-based training in dental, jaw, and related surgery. Extractions can be done using local or general anesthesia or intravenous
sedation depending on the complexity of the extraction and the patient's preferences. The patient is usually given antibiotics
to combat infection and medication to manage pain following the extraction.
Although dentists agree that extraction is the appropriate treatment for an impacted tooth that is causing health problems, there are two philosophies on whether impacted wisdom teeth should be routinely removed. One school of thought is that impacted wisdom teeth are likely to cause health problems and that they should be removed before these health problems arise. The dentists supporting this position point out that wisdom teeth are much easier to remove and healing is much faster in adolescents than in older individuals, because younger people have more flexible bones. The other philosophy is that although some wisdom teeth should be removed, all wisdom teeth do not need to be routinely extracted when no problems have occurred. People who support this position note that not all impacted wisdom teeth cause problems. People with impacted wisdom teeth should discuss their individual situation with their dentist and review the pros and cons of extraction of teeth that are not yet causing health problems before making treatment decisions.
See also Cavities
• Mouth Disorders: Overview
American Association of Oral and Maxillofacial Surgeons. 9700 W. Bryn Mawr Ave., Rosemont, IL 60018-5701. Telephone: 847-678-6200. Website:
(accessed July 20, 2015).
American Dental Association. 211 E. Chicago Ave., Chicago, IL 60611-2678. Telephone: 312-440-2500. Website:
(accessed July 20, 2015).
* intravenous (in-tra-VEE-nus), or IV, means within or through a vein. For example, medications, fluid, or other substances can be given through a needle or soft tube inserted through the skin's surface directly into a vein.
* antibiotics (an-tie-by-AH-tiks) are drugs that kill or slow the growth of bacteria.