Lewis D. Gilbert, DDS, LTD

Frequently Asked Questions About Impacted Teeth

Written By Dr. Adonis Terezides

Wisdom Teeth and the upper canines are the most common impacted teeth. Treating impacted wisdom teeth is fairly simple and involves surgical removal of the entire tooth. When canines are impacted, the treatment is more complex as these teeth are vital to a healthy bite and good aesthetics.

Treatment of impacted canine teeth often involves cooperation with your orthodontist to make room for the canine, by shifting the teeth with braces, surgical exposure of the impacted tooth by the oral surgeon with placement of an orthodontic bracket to allow the orthodontist to guide the impacted tooth into place with orthodontic appliances.

When a tooth becomes stuck in the jawbone and either emerges only a small bit or does not break through the gums at all, it is said to be impacted. An impaction can cause a wide range of complications, including improperly aligned bite, pain and infection. The following are the most frequently asked questions about impacted teeth.

  • What causes teeth to become impacted?  Impacted teeth occur when full tooth eruption does not take place. This condition can occur because a person’s jaw is too small to accommodate the teeth; if the existing teeth are not in the right position, preventing the normal eruption of the impacted tooth; if the impacted teeth are growing in at an abnormal angle; or if there is a benign cyst or tumor, a retained baby tooth that fuses to the bone preventing the permanent tooth from erupting, or overlying soft tissues preventing the eruption.
  • Which teeth most commonly experience impactions? The wisdom teeth most commonly become impacted as they emerge in the back of the mouth long after all of the other teeth have erupted. The maxillary canines, also called cuspids or eye teeth, are the second most common teeth to experience impactions.
  • What symptoms are present with impacted teeth? Neither impacted canines nor wisdom teeth are likely to produce any symptoms at all. Typically, these are discovered by your dentist or your orthodontist when they take x-rays. Later in life, when a wisdom tooth (third molar) does not erupt properly, it can cause jaw and gum pain in the back of the jaw, caused by an infection of the gums called periocoronitis, and difficulty opening the mouth or chewing. You see, when there is not enough room for wisdom teeth to full erupt, they come partly through the gum tissue. Wisdom teeth, like all teeth, have an enamel covering. Enamel is very hard, and very slick. Gum tissue will not “stick” to enamel, so a gum flap results. When you chew, food gets pushed under the gum flap and accumulates, causing potential for infection – called pericoronitis. When it occurs in the lower jaw, the infection can progress through the tissues of the mouth to the neck, potentially causing a life threatening infection.
  • How are impacted wisdom teeth treated? Because impacted wisdom teeth can cause damage to surrounding teeth and are not functional, surgical removal of third molars is the treatment of choice. The oral surgeon creates an opening in the gums and the bone, he typically sections the tooth to allowed reduced trauma to the jaw, he removes the tooth and its roots and closes the incision with sutures. This is one of the most commonly performed procedures in the field of oral surgery.
  • How are impacted canines treated? Unlike impacted wisdom teeth, canines are critical for a properly aligned bite and good cosmetic appearance. Canine teeth are often called the “the cornerstone of the occlusion”, so your oral surgeon will work together with your orthodontist to help assist the eruption of these teeth. If caught early enough, sometimes by orthodontically creating enough space for the tooth to erupt on its own, surgery can be avoided.  If the tooth does not erupts on its own, the oral surgeon can make an incision into the gums to expose the impacted tooth, attach an orthodontic bracket and the orthodontist will guide that tooth downward and into its proper position.