Impacted Teeth: Symptoms, Diagnosis and Treatment

What Are Impacted Teeth? How To Diagnose, Treatment Methods, and More

An impacted tooth is a tooth that has not passed through the gum-line to grow into position on its own.

Instead, the tooth remains stuck – or “impacted” – in the gum tissue or bone. This can cause dental problems and other health concerns if left untreated.

There are several causes of impacted teeth, and a variety of methods for treating the issue. This guide will help you understand impacted teeth, why it’s important to treat this condition, and how expert orthodontic care can fix it.

What Are Impacted Teeth?

Impacted teeth occur when the teeth can’t grow in properly on their own; either something is obstructing their movement – such as the baby teeth not falling out – or there is not enough room for all the teeth. This causes the teeth to get stuck, sometimes barely pushing out from the gumline, or not visible at all under the gums.

Some people may have several impacted teeth, while others have only one. This depends on the causes of impacted teeth and how the teeth grow in. Alternatively, some people have impacted baby teeth, but their adult teeth grow in properly, or vice versa. It all depends on your unique teeth.

While impacted teeth may not cause pain or discomfort – you may not even know it’s there – it’s important to monitor it and, in some cases, to treat it. This can mean drawing it out to its proper position or extracting it.

Impacted Baby Teeth

When a baby tooth won’t fall out on its own, it may become submerged in the gum line or impacted and require intervention to remove it. It is uncommon, but in certain cases, these teeth can stubbornly refuse to fall out. This has a reciprocal effect on the adult teeth, which have no room to grow in properly and thus can either can get impacted themselves or grow in at a problematic angle.

An x-ray will help determine whether the baby teeth are causing improper growth of the adult teeth, and in some cases, the affected baby teeth will be removed early to leave room for the adult teeth. This is one of the reasons why early orthodontic intervention can be extremely useful: The American Association of Orthodontists recommends children see an orthodontist by age 7.

Impacted Wisdom Teeth

The most common impacted teeth condition is wisdom teeth, the last set of molars, which often don’t grow in due to lack of room in the mouth. Many people will have these impacted teeth removed in their teenage years or early twenties.

Impacted teeth don’t generally cause pain, but the condition should be carefully observed and treated if necessary. If left untreated over time, impacted teeth may cause dental damage, pain, or other health issues. If impacted third molars do not cause any issues or show any potential problems, dental professionals recommend careful observation to monitor any changes.

What Causes Impacted Teeth?

There are multiple causes of impacted teeth; an impacted tooth can be caused by one or multiple of the following factors.

Common Causes of Impacted Teeth:

The tooth has twisted or grown in at an angle that won’t fit, so it stops pushing through
Other teeth in the mouth have overcrowded the space for that tooth to grow in
The jaw is too small to fit more teeth, causing some to grow in and others to stop
The tooth is too big to fit in the space where it needs to grow
Genetic factors affecting the teeth or jaw
Accidental damage to the baby tooth affects the erupting adult tooth beneath, causing the adult tooth to become impacted

Since you grow two sets of teeth throughout your life, baby teeth and then adult teeth, there is a possibility of a tooth getting impacted and failing to grow in at either stage.

Baby Teeth Can Cause Impacted Adult Teeth

The causes of impacted teeth may be genetic – especially a mismatch between the size of your teeth and the size of your jaw – or could be caused by external factors, like premature loss of baby teeth, due to an accident or other mouth trauma.

Adult teeth can be impacted due to improper growth or delayed loss of baby teeth. This is common with the canine teeth (also called cuspid or upper eyeteeth). Delayed or premature loss of the first set of canines can stop the growth of adult canines, causing them to become impacted.

Causes of Impacted Wisdom Teeth

The wisdom teeth are the last teeth to grow in, erupting typically between 17-21 years of age. Wisdom teeth are vestigial: they were useful for our human ancestors, who had to chew much tougher raw foods than we do now, but we no longer need such robust molars. Over time, our jaws shrank – but wisdom teeth remain.

For some individuals, there will be enough room in the jaw for the wisdom teeth and they can grow in normally, but for many people, wisdom teeth get impacted without enough room to grow in.

Impacted teeth can cause pain or jaw damage. They also can stay impacted without any negative consequences – it depends on the specific case.

If they are impacted, your dentist or orthodontist will observe your wisdom teeth and determine whether they should be removed. Extraction of impacted third molars (wisdom teeth) requires oral surgery and can be a complex procedure. Therefore, observing the wisdom tooth impaction is important, since removal may not always be necessary. Ask your orthodontist for their professional counsel regarding your wisdom teeth.

What are the Signs of Impacted Teeth?

You may or may not be able to see the impacted tooth: sometimes, it is visible at the gum line, but stuck from growing in further. In other cases, it may be still entirely embedded in the gums, and you cannot see it.

X-rays help your orthodontist determine the position of the impacted teeth, even if you can’t see it in your mouth.

Other signs to look out for that may be evidence of an impacted tooth:

Bad breath
Bad taste in your mouth
Gum tenderness or pain
Swollen, red, or painful gums
Gaps in teeth
Headaches
Jaw aches
Pain when opening your mouth
Difficulty or pain when chewing, biting, or swallowing
Premature or delayed loss of baby teeth

If you have crowded teeth, it can be difficult to assess whether a tooth has grown in or not just by looking at your teeth: visiting an orthodontist is important since they can take x-rays to examine which teeth may not have grown in properly.

If you have any of these signs, consult a licensed, experienced orthodontist who can examine your teeth, take x-rays and diagnostic records, and assess whether there is a need for treatment.

Are Impacted Teeth Bad for the Health of Your Mouth?

It is important to treat impacted teeth because leaving them alone can have serious consequences for your other teeth, as well as your overall health.

Consequences of Impacted Teeth:

Cosmetic issues
Abscesses (pockets of infection)
Damage to the neighboring teeth
Tooth decay or loss
Bite or chewing problems
Jaw pain and headaches
Gum inflammation
Periodontal disease

It’s important to treat impacted teeth, either by extraction or with orthodontic treatment.

Visiting an orthodontist will allow a licensed professional to examine your teeth, using x-rays to see what’s below the gum-line, to establish whether certain teeth are impacted, and make a plan for treating them.

How to Treat Impacted Teeth

There are a variety of options for treating impacted teeth. Your orthodontist will do a thorough examination and recommend the correct course of action.

Treatment depends on various factors:

Whether the teeth are baby or adult teeth
Whether intervention can help them grow in properly
The nature or severity of the impacted condition.

Treating Impacted Baby Teeth

Treating impacted baby teeth is different than adult teeth because loss is inevitable: whether the impacted tooth is removed manually or not, the tooth needs to come out eventually for the adult teeth to grow.

For that reason, extraction is a common treatment for impacted baby teeth, but not always the solution. Your child’s dentist and orthodontist will work together to determine the best course of action for an impacted baby tooth.

When it comes to treating impacted baby teeth, the most important goal is always to minimize potential complications later on, resulting in more complex orthodontic interventions. Early treatment and consultation with an orthodontist can reduce the need for complex, expensive care later on.

Treating Impacted Adult Teeth

With impacted adult teeth, there are more factors to consider:

Is it possible to “rescue” the tooth, rather than extracting it?
Is there enough space for it to grow in, and can space be created?
What effect is the impacted tooth having on the other adult teeth?

Treating impacted teeth requires careful, precise interventions, and the supervision of a licensed, experienced orthodontist.

Extractions with Oral Surgery

Depending on the severity or placement of the impacted tooth, as well as the positioning of the rest of the teeth, the most effective treatment may be to simply extract the impacted tooth.

This requires oral surgery from a dedicated oral surgeon or dentist with extraction experience. Extractions will generally take place before beginning orthodontic care. If oral surgery is necessary, your dentist or orthodontist will give you a referral for the procedure. Oral surgery requires a referral from another dental professional.

Adult Braces Patient Smiling with Silver Bands

Treating Impacted Teeth with Braces

There are many useful, effective, and safe interventions for impacted teeth using braces treatment.

Metal or ceramic braces may be used to treat an impacted tooth, under the supervision of an experienced orthodontist.

One such treatment method involves a simple surgery to open the gum and expose a small piece of the impacted tooth. A small ring is then affixed to the tooth, which attaches to the braces wire with a small chain. The consistent tension of the chain slowly coaxes the tooth out of its impacted position, into place with the other teeth.

Once the tooth has come down, traditional braces treatment can be used to adjust it into proper alignment.

Person Holding Invisalign Aligner with Case

Treating Impacted Teeth with Invisalign Clear Aligners

Whether Invisalign treatment can help extrude impacted teeth depends on the severity of the diagnosis. In certain cases, Invisalign aligners can help align impacted teeth – but generally, this condition requires other treatment first, before moving on to Invisalign with the supervision of an experienced orthodontist.

It is possible to draw out an impacted tooth with Invisalign aligners by utilizing special metal attachments and specific techniques. Make sure to choose an experienced, qualified Invisalign provider, not an off-brand clear aligner provider or DIY at-home kits.

After the impacted teeth have been brought down, the metal attachments can be removed and treatment continued with traditional Invisalign clear aligners, for a discreet and effective treatment to straighten all the teeth into their correct positions.

If extractions are necessary, this will take place before the Invisalign treatment begins.

If you are interested in Invisalign clear aligners and have impacted teeth, consult with a licensed, experienced orthodontist about potential solutions.

Do not seek treatment from a teledentist using at-home, mail-order aligners: these companies may approve you for treatment without ever having a comprehensive picture of your condition, which can cause serious, permanent damage to your teeth and mouth.