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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Impacted Teeth

Impacted third molars (wisdom teeth) are very common. One explanation may be that modern man has a smaller jaw than his early ancestors but similar-size teeth.

What is it?

An impacted tooth is one that cannot emerge normally (erupt) from the gums and/or becomes displaced. Most often, the third molars (wisdom teeth) that complete their development in the late teens or early twenties become impacted because the jaw is too small to properly accommodate any more teeth. A tooth may also be positioned at an angle before it emerges and thus travel sideways instead of straight. Finally, another tooth may stand as an obstacle and cause a new tooth to erupt abnormally or prevent it from surfacing altogether.

Although wisdom teeth are most frequently impacted, any tooth may fail to erupt or erupt in an abnormal position. An improperly placed or partially emerged tooth may easily trap food debris and encourage infection and inflammation of the gums. When impaction produces such complications, extraction of the tooth is generally advised. Cysts and tumors may occur around impacted teeth. Any impacted teeth that are likely to become infected or cause damage should be removed.

What Causes It?

  • Overcrowding of the teeth within the jaw.
  • Faulty alignment of teeth (which may result in misplacement and impaction).

Prevention

  • Proper dental care during childhood and adolescence, including orthodontic braces if necessary, may prevent impaction.

Diagnosis

  • Dental examination.
  • Dental x-rays.

How to Treat It

  • Until you can see a dentist, over-the-counter pain relievers can be taken for minor tooth pain and discomfort. Rinsing with mouthwash or a solution of warm salt water may be soothing as well.
  • Antibiotics are prescribed when bacterial infection occurs at the site of the impacted tooth.
  • Surgical extraction is the definitive treatment for an impacted tooth that causes problems. Depending upon the position of the tooth, extraction may be performed in the dentist's office under local anesthesia; more complicated extractions should be performed by an oral surgeon and may require sedation or general anesthesia.

When to Call a Doctor

  • Make an appointment with a dentist if you develop tooth or gum pain or if a tooth fails to emerge.