Tooth Impaction: Symptoms and Treatments
Impacted teeth are a tooth which does not break through the gums. During infancy or the first year of a patient’s life, the teeth begin to erupt and pass through the gums. This process takes place a second time when the primary or baby teeth are replaced with the secondary or adult teeth.
Teeth which do not properly erupt, or only partially emerge, are considered to be impacted. The most common teeth to be impacted are the third molars or the wisdom teeth. These are also the last teeth to erupt and typically come in when the patient is between 17 and 21 years old.
There are various reasons why an impacted tooth can get stuck in gum tissue or bone. In some cases, the area is overcrowded and lacks enough room for the tooth to emerge. Patients with a smaller jaw often do not have room for their wisdom teeth. The teeth can also become twisted, tilted, or displaced during their development and the result is impacted teeth.
Impacted wisdom teeth are quite common and often do not cause any issues. In some cases, however, the impacted teeth can push against the adjacent teeth and can result in problems such as a misaligned bite or overcrowding. Teeth which are partially emerged can accumulate food, plaque, and other debris resulting in inflammation, bad breath, and pain. Over time, this debris can cause decay of the wisdom teeth, adjacent teeth, or even bone loss.
In some cases, an impacted tooth may not cause any symptoms. However, many patients experience one or more of the following symptoms:
1. Bad breath or taste in the mouth
2. Challenge with opening the mouth
3. Pain in the jaw or gums
4. Chronic head or jaw ache
5. Red or swollen gums
6. Swollen lymph nodes
7. Visible gap
The dentist will examine the mouth and look for signs of swollen tissue where the impacted tooth is located. It is possible the impacted tooth is pressing against the adjacent teeth and could cause shifting. Gum tissue around the area can also begin to show signs of infection including redness, drainage, and tenderness. When the gums swell over an impacted wisdom tooth and then drain, it can feel as though the tooth erupted and went back down. The dentist will typically use x-rays to confirm if a patient has one or more impacted teeth.
Treatment
When an impacted wisdom tooth does not cause any issues or symptoms, it may not require treatment. The dentist will likely monitor the tooth to ensure it does not become an issue. Impacted teeth located towards the front of the mouth may require braces to aid in directing the tooth into the correct location.
When an impacted tooth is causing discomfort, patients can use an over-the-counter pain reliever. It can also be helpful to use a warm saltwater rinse using ½ teaspoon of salt and one cup of filtered water. A gentle mouthwash can also help provide temporary relief.
In most cases, the dentist or oral surgeon will recommend removing an impacted wisdom tooth. If there is infection present, the dental professional will prescribe antibiotics prior to the extraction. Impacted teeth can cause significant discomfort for some patients and result in no symptoms for others. The treatment is most successful when the impacted tooth is removed prior to the presence of any symptoms.
Most dental professionals recommend removing impacted wisdom teeth before the patient is 20 because the roots are not yet fully developed. This makes the tooth easier to remove and can help expedite the healing process. Over time, the roots grow longer, can become curved, and the bone becomes more rigid, ultimately increasing the likelihood of complications and issues.