Impacted tooth: what it is and why the tooth did not erupt

You heard the dentist say "impacted tooth" or saw on an X-ray a tooth that never came through. It sounds scary, but it means the tooth could not erupt and is covered by bone or gum. Let's calmly sort out what this is and why it happens.

What an impacted tooth is

An impacted tooth is a tooth that cannot erupt properly because it is fully or partially covered by bone or gum tissue. It remains in the jaw and does not appear in the oral cavity. Most often this concerns wisdom teeth, but it can also happen with other teeth, such as canines. In impacted canines, the most common cause is early loss of primary teeth and an incorrect position of the tooth crown.

Why wisdom teeth remain in the gum or grow horizontally

Wisdom teeth develop later than the others and usually begin to erupt in adolescence or around age 20. But they may not have enough space to fully come into the mouth. Then they press against the adjacent tooth or are partially covered by the gum. Due to lack of space, they often try to erupt at an angle or horizontally relative to the rest of the dentition. This leads to pressure on adjacent teeth and their destruction over time.

How an impacted tooth is detected on an X-ray

Usually the dentist may suspect the problem during an examination: they ask about symptoms, examine the teeth and check them with instruments. An X-ray is not always needed, but in some cases it is. If it is necessary, radiography is performed, for example a panoramic image, and in complex cases — 3D tomography. These studies clearly show the location of impacted wisdom teeth and help the doctor plan further actions.

Possible complications and pain in the area of the tooth

If an impacted tooth does not cause concern, it is often left in place and monitored at regular checkups. But sometimes it creates problems: pain and swelling, gum infections (pericoronitis), food trapping, caries, gum disease, fluid accumulation around the tooth (cyst), dental abscess. In such cases, the doctor may recommend removal. Removal is usually necessary for pericoronitis (infection of the soft tissues around the tooth), osteomyelitis (inflammation of the jaw in the area of impaction), the tooth being located in a follicular cyst, caries on it, a cyst or benign formation, purulent abscesses. Surgery is usually performed under local anesthesia, and in an uncomplicated case the tooth is left and monitored at routine checkups.

• Pain and swelling in the area of the wisdom tooth
• Food trapping
• Unpleasant taste in the mouth, especially together with pain
• Swelling of the gum or cheek

The presence of an impacted tooth by itself is not a reason to call an ambulance; 103/112 — if bleeding does not stop or pain and swelling rapidly increase with a high temperature and sharp deterioration in well-being.

When to see a dentist

You should see a dentist if you feel pain or swelling in the area of the impacted tooth, if food gets stuck or there is an unpleasant taste in the mouth, especially together with pain. If the tooth does not cause concern, but you know about its impacted position, still see the dentist at routine checkups — they will decide whether observation or intervention is needed.

This material is for reference purposes and does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer