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What Is an Impacted Tooth?

An impacted tooth is a tooth that gets blocked as it is pushing through the gum into your mouth (erupting). Wisdom teeth often are impacted.

Wisdom teeth usually begin to come in between the ages of 17 and 25. Dentists call these teeth third molars. These are the last teeth to erupt, and they normally erupt into a position closely behind the last standing teeth (second molars). Space for these teeth to erupt can be limited. Wisdom teeth often fail to erupt or erupt only partially, which is often due to impaction of the wisdom teeth against the second molars (teeth directly in front of the wisdom teeth). In most cases, this occurs when second molars are blocking the path of eruption of third molar teeth and act as a physical barrier, preventing complete eruption. They may become impacted because there is not enough room in your mouth for them. A wisdom tooth also might be trying to come in sideways. Or, it might be tilted in your jaw.

An impacted tooth can be painless. You may not even realise it is there. However, when an impacted wisdom tooth tries to come in, the flap of gum on top of it can become infected and swollen. This can hurt. You might even feel pain in nearby teeth, or in the ear on that side of your face.

An impacted tooth can lead to an infection called pericoronitis. If untreated, this infection can spread to the throat or into the neck.

Impacted teeth can also decay. An impacted tooth can push on the neighbouring molar. This can lead to decay in the tooth in front of the wisdom tooth and gum disease can occur due to the angle of the wisdom tooth and the difficulty of cleaning well around it and the tooth in front. Rarely, impacted teeth can cause cysts or other growths in the jaw.

When To Call Your Dentist

Call your dentist if you feel pain in your back teeth. 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 taken out. Your dentist may take extra X-rays to check your wisdom teeth. Routine X-rays often don’t show these teeth.

Symptoms

Symptoms include:
• Swelling of the gum in the back of your mouth
• Difficulty opening your jaw (trismus)
• Bad breath
• A bad taste in the mouth
• Pain when you open your mouth
• Pain when chewing or biting.

Pain can occur for several days and then disappear. It can come back weeks or months later.

Diagnosis

Your dentist will examine the area. If necessary, he or she will take X-rays. X-rays can show where your wisdom teeth are and if they are impacted.

Prevention

There is no way to prevent an impacted wisdom tooth, but you can prevent decay by brushing and flossing well and this will also reduce the chances of gum disease and infection occurring.

Treatment

You can sometimes relieve minor irritation by rinsing with warm salt water (teaspoon of salt added to a small cup of boiled water). Anti-inflammatory painkillers like ibuprofen can also help. To aid resolution in minor cases tough, chewy foods should be avoided and you should try and eat all your food on the opposite side of your mouth to where the pain is.

If the tooth continues to cause pain, is infected or interferes with nearby teeth, the usual treatment is to extract the tooth. Antibiotics are sometimes prescribed if the infection is considered severe.

Patients are often referred to an oral or maxillofacial surgeon within a hospital or specialist practice to have an impacted tooth removed as minor surgery is sometimes required to remove an impacted wisdom tooth. This is generally a procedure carried out under local anaesthesia and there is no need to stay in hospital after the procedure.

After the surgery you may have swelling of the cheeks and jaw. It may be hard to eat certain foods. Follow your dentist’s or surgeon’s instructions carefully for the best recovery. Stitches (sutures) are often placed to allow the gum to heal properly. Generally, these stitches are dissolvable so there is no need to return to see your surgeon after the extraction.

Do All Impacted Wisdom Teeth Need Extracted?

An impacted tooth may not bother you or affect nearby teeth. In this case, you won’t need immediate treatment. However, your dentist may recommend that the tooth be taken out to avoid future problems. For example, it can be very difficult to keep impacted teeth and the tooth beside it clean due to the angle the impacted tooth has come through, so the impacted wisdom tooth is taken out before any decay or gum disease occurs.