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Impacted Wisdom Tooth
Impacted Wisdom Tooth
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 tooth
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
- Bad breath
- 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:
- Abscess of the tooth or gum area
- Chronic discomfort in the mouth
- Infection
- Malocclusion of
the teeth
- Plaque trapped between teeth
and gums
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.
Alternative Names
Tooth - unemerged;
Unemerged tooth; Dental impaction; Unerupted tooth
References
Buttaravoli P, Leffler SM, eds. Dental pain,
pericoronitis. Minor Emergencies. 3rd ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 46.
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