An impacted tooth is a tooth that does not erupt (come in) the way it should. Instead of breaking through the gum line, it becomes stuck in the gum tissue or the jawbone or only partially erupts. Some impacted teeth cause symptoms while others are found during an exam or on Radiographs.
Learn everything you need to know about impacted teeth from the experts at the American Association of Orthodontists.
Bite-Sized Facts About Impacted Teeth
- An impacted tooth is “stuck,” meaning it cannot fully come in because something is blocking it, it has taken the wrong pathway, or there isn’t enough room.
- Wisdom teeth are the most commonly impacted and the most common.
- Some impacted teeth cause pain, swelling, and infection while others cause no symptoms at all.
- Impacted canines are especially important in orthodontics because they help guide a healthy bite and support your smile’s appearance. (Your orthodontist can determine the best approach for guiding eruption.)
AAO recommends that children visit an orthodontist no later than age 7 to help identify eruption and spacing concerns early.
What Causes Impacted Teeth?
An impacted tooth occurs when a tooth fails to break through the gum line. A lack of space in the mouth, an incorrect angle of eruption, or an obstruction can cause an impaction. Family history also influences the likelihood of having impacted teeth.
The most common causes of impacted teeth include:
- Lack of space in the jaw
- Tooth erupting at an incorrect angle
- Crowding or overlap from neighboring teeth
- Obstructions in the eruption path
- Family history or genetic factors
Symptoms of an Impacted Tooth
Some impacted teeth do not cause obvious symptoms. When symptoms do occur, they often involve the gums or jaw near the impacted tooth.
Common signs and symptoms may include:
- Jaw pain or tenderness
- Pain when opening your mouth
- Gum sensitivity near the affected area
- Redness or swelling of gum tissue
- A visible gap where a tooth has not erupted
- Bad breath or a bad taste, which can be a sign of infection
If you notice swelling, worsening pain, drainage, or fever, call your dental provider promptly.
How Do Impacted Teeth Affect Your Health?
Impacted teeth are not just a cosmetic concern. Depending on the tooth and how it is positioned, impaction can contribute to:
- Gum irritation and infection
- Tooth decay in hard-to-clean areas
- Damage to nearby teeth or roots
- Cyst formation around the impacted tooth
- Shifting and crowding that affects alignment and bite
How Does an AAO Orthodontist Diagnose Impacted Teeth?
The problem with impacted teeth is that they can occur below the gumline where eyeballing it won’t tell you what’s going on. Your orthodontist has different technologies at their disposal that can take a peek below the gumline to get a good look at what’s happening. Diagnosis typically includes:
- A clinical exam to check eruption patterns, spacing, and bite
- Dental imaging (often X-rays, and sometimes 3D imaging) to see where the tooth is positioned and whether it is affecting nearby teeth
This information helps determine whether the tooth can be guided into place, should be monitored, or needs removal.
How Are Impacted Teeth Treated?
Treatment depends on the tooth involved, the position of the tooth, your symptoms, and how the impaction affects nearby teeth. If you have an impacted tooth, your orthodontist will discuss your options with you.
Common treatment approaches include:
Monitoring
If an impacted tooth is not causing damage or symptoms, a provider may recommend monitoring with periodic exams and imaging.
Creating Space and Guiding Eruption
When lack of space contributes to impaction, orthodontic treatment may create room so a tooth can erupt more normally. Appliances such as palatal expanders may be used to create more space and guide the tooth into the proper place.
Surgical Exposure and Orthodontic Traction
For certain impacted teeth, especially canines, treatment may involve a coordinated approach with an oral surgeon and orthodontist. A common method is surgical exposure of the tooth followed by bonding an attachment so the orthodontist can apply gentle traction to guide the tooth into position over time.
Removal
When a wisdom tooth is impacted and causing pain, infection, or damage risk, removal may be recommended. Impacted wisdom teeth are extremely common, and they can contribute to infection, tooth decay, and gum disease when they are difficult to clean. That’s why orthodontists and dental professionals typically recommend getting wisdom teeth removed.
How Does An Impacted Tooth Affect Orthodontic Treatment?
Because impacted teeth have a tendency to force teeth to move around in the mouth, they present an obstacle for orthodontic treatment. This usually results in the sequence of orthodontic care being changed to accommodate for treating the impacted tooth.
Your orthodontist may need to create space before a tooth can be guided into the arch. Treatment may even include coordination with an oral surgeon for exposure and traction in cases like impacted canines.
Frequently Asked Questions About Impacted Teeth
How Common is Tooth Impaction?
Tooth impaction is not rare. Most people will experience this in their late teens to early 20s. Your orthodontist may recommend removing a wisdom tooth if it is causing problems. However, nearly 85% of people will have a wisdom tooth extracted during their lifetime.
Do impacted teeth always hurt?
No. Some impacted teeth cause pain, swelling, and infection, while others cause no symptoms and are discovered on Radiographs.
Can an impacted tooth affect my bite?
Yes. Depending on the tooth and its position, impaction can contribute to shifting, crowding, and bite problems, and it can affect the alignment plan for braces or aligners.
Can Children Get Impacted Teeth?
Yes. Eruption issues can also affect younger patients. Sometimes baby teeth become impacted or ankylosed (fused to the bone) and do not fall out as expected, which can block the eruption of adult teeth.
Because eruption and spacing issues can start early, AAO recommends a first orthodontic visit no later than age 7. That early check can help identify developing problems, including eruption concerns that could lead to impaction.
Trust an AAO Orthodontist for Impacted Teeth Treatments
Impacted teeth are common and treatable, but they are not something to ignore. An impacted tooth may stay trapped under the gums, partially erupt, or push against neighboring teeth. Treatment depends on which tooth is impacted, where it is located, and whether it is affecting your oral health or your bite. In many cases, early diagnosis and a well-planned approach can prevent more complicated issues later.
If you have been told you have an impacted tooth, or you suspect a tooth is not coming in as expected, an orthodontist can help you understand your options. Use the AAO Locator to find an orthodontist near you and schedule a consultation to get a clear diagnosis and a treatment plan designed for a healthy, lasting result.
