Impacted Tooth

Overview

An impacted tooth is a tooth that cannot come through the gum into its normal position. It may be fully stuck under the gum, partly through, or growing at an angle. This most often happens with wisdom teeth and upper canine teeth, but it can affect other teeth too.

Yes. Impacted teeth are common, especially wisdom teeth. Many people have at least one impacted tooth at some point.

It can affect children whose adult teeth are coming through, teenagers and young adults whose wisdom teeth are developing, and older adults who still have wisdom teeth or other crowded teeth. People with a small jaw, crowded teeth, or a family history of impacted teeth may be more likely to have them.

Symptoms

Common symptoms

• No symptoms at all, especially if the tooth is fully buried
• Pain or pressure in the jaw or around the tooth
• Swelling or tenderness of the gum near the tooth
• A tooth that is only partly visible through the gum
• A gum flap over the tooth that becomes sore or swollen
• Bad breath or a bad taste if food and bacteria get trapped
• Difficulty opening the mouth fully or chewing comfortably

Symptoms in children

• A baby tooth that does not fall out because the adult tooth is trapped
• A swollen or tender gum where an adult tooth should appear
• Pain when biting or brushing near the area
• A tooth coming through in the wrong place or at an odd angle
• Sometimes no obvious signs, so dental check-ups are important

Symptoms in older adults

• Wisdom tooth pain or pressure that comes and goes
• Gum infection around a partly erupted tooth
• Jaw stiffness or discomfort when opening the mouth
• Tooth decay in a tilted or hard-to-clean tooth
• Damage to the tooth next to the impacted one

Causes

Main causes

• Not enough room in the jaw for the tooth to come through
• The tooth growing at an angle or in the wrong direction
• Crowded teeth pushing against each other
• An extra tooth or other structure blocking the way
• Thick or tough gum tissue that the tooth cannot break through
• Jaw size and shape, which are often inherited

Risk factors

• Having wisdom teeth, which are the most commonly impacted teeth
• A small jaw or crowded teeth
• A family history of impacted teeth
• Being a teenager or young adult when wisdom teeth develop
• Certain growth or developmental conditions that affect the jaw and teeth
• Poor gum health, which can make symptoms around a partly erupted tooth worse

When to see a doctor

See a doctor urgently if:

• You have severe pain, facial swelling, fever, or pus
• You cannot open your mouth properly or have trouble swallowing
• A gum infection around the tooth is spreading or getting worse
• You have a tooth injury with bleeding that will not stop

Book a routine appointment if:

• A tooth has not come through when expected
• You feel pressure or mild discomfort in the jaw that keeps returning
• You notice a partly erupted tooth or a sore gum flap
• You have bad breath or a bad taste that does not go away
• A dental X-ray has shown an impacted tooth, even if it does not hurt

Diagnosis

A dentist or doctor will ask about your symptoms and examine your mouth, gums, and jaw. They may look for a tooth that has not come through, a swollen gum flap, or crowded teeth. Dental X-rays are usually needed to see the tooth's position under the gum and check nearby teeth.

Tests that may be done

• Dental examination of the mouth, gums, and jaw
• Dental X-ray of the tooth and nearby teeth
• Panoramic X-ray to show all teeth and the jaw
• A dental CT scan in some cases, if the tooth is close to nerves or other important structures

What to expect at your appointment

The examination is usually quick and not painful. X-rays are painless and help your dental team see exactly where the tooth is. If needed, they may refer you to a dentist with special training in oral surgery or orthodontics for further advice.

Treatment

Treatment depends on your symptoms, the tooth's position, and whether it is causing problems. Some impacted teeth are simply watched with regular check-ups. Others may need cleaning around the tooth, treatment for gum infection, removal, or orthodontic care to help the tooth come through.

Self-care at home

• Keep the area as clean as you can with gentle brushing
• Use a soft toothbrush and avoid poking the gum with sharp objects
• Rinse gently with warm salt water if your dental team advises it
• Choose soft foods if chewing is sore
• Place a cold pack on the outside of your cheek for swelling, wrapped in a cloth
• Avoid very hard, sticky, or chewy foods that may trap debris or hurt the gum

Medical treatments

Your dental team may clean around the tooth, treat any gum infection, and give you advice on keeping the area healthy. If the tooth is causing repeated problems or damaging nearby teeth, they may recommend removal. In some cases, braces or other orthodontic treatment can help guide a tooth into place. Your clinician will explain the choices, benefits, and risks so you can decide together.

When is surgery considered?

Removal may be suggested if the impacted tooth causes repeated gum infection, pain, decay, damage to the tooth next to it, a cyst, or problems with braces. It may also be advised if the tooth is very hard to keep clean. Not every impacted tooth needs surgery, and your dental team will discuss whether watching it is safer for you.

Living with this condition

Most people can live normally with an impacted tooth. Keep up gentle cleaning, notice any new pain or swelling, and go to your regular dental check-ups. If your dentist is watching the tooth, ask when you should come back and which symptoms mean you should call sooner.

Lifestyle tips

• Brush twice a day and clean between your teeth as your dental team shows you
• Attend regular dental check-ups so the tooth and nearby gums can be checked
• Avoid smoking, which can worsen gum health
• Eat a balanced diet and limit sugary snacks and drinks
• If you grind or clench your teeth, ask your dentist for advice
• Tell your dentist about any new pain, swelling, or bad taste

Diet and exercise

There is no special diet that fixes an impacted tooth, but soft, nourishing foods can help when the area is sore. Avoid very hard or chewy foods that may hurt the gum or get trapped. Gentle exercise is usually fine. If you have swelling or infection, rest and follow the advice from your healthcare team.

Mental health and emotional wellbeing

Dental pain or worry about a procedure can make people feel anxious or stressed. This is common and worth talking about. If dental worry is affecting your sleep, mood, or daily life, tell your dentist or doctor. If you ever have thoughts of harming yourself, contact your local crisis support service or emergency services right away.

Prevention

Impacted teeth cannot always be prevented, because jaw size and tooth position are often inherited. Regular dental check-ups are the best way to find problems early. Good oral hygiene helps keep the gums around a partly erupted tooth healthy.

Vaccines

There is no vaccine for impacted teeth.

Screening programmes

Regular dental check-ups and X-rays when advised are the main way to find impacted teeth early. Children and teenagers may need check-ups as their adult teeth come through.

Complications

If left untreated

• Gum infection or abscess around a partly erupted tooth
• Tooth decay in the impacted tooth or the tooth next to it
• Damage to nearby teeth or roots
• A fluid-filled sac called a cyst around the tooth
• Crowding or movement of other teeth
• In rare cases, infection can spread into the jaw, neck, or other areas and become serious

Long-term outlook

Most people with an impacted tooth do well, especially when it is checked early and kept clean. Many impacted teeth never cause trouble. If problems do arise, your dental team can discuss treatment options with you. Seeking care for severe swelling or breathing or swallowing trouble quickly is important.

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