An impacted teeth is one that fails to erupt into the dental arch within the expected developmental window. The third molar (wisdom teeth) usually begin to come in between the ages of seventeen and twenty one.
The failure of the eruption of third molar could be due to:
- Lack of sufficient space in the person ‘s jaw to accommodate the tooth.
- The tooth’ s eruption path is obstructed by other teeth.
- Because the angulation of the tooth is improper.
There are basically three types of impaction:
Horizontal impaction – The impacted tooth lies in a flat position within the bone.
Vertical impaction - The tooth lies in a straight position within the bone.
Mesial or distal impaction – The tooth lies in an angulated position within the bone.
Symptoms of Impacted Teeth
The following symptoms could be experienced by patients during the presence of an impacted tooth-
- Difficulty in opening your jaw
- Swelling of the gum in the back of your mouth
- Bad breath
- A bad taste in the mouth
- Pain when you open your mouth
- Pain when chewing or biting
- Pain can occur for several days and then disappear. It can recur after weeks or months later.
Diagnosis of Impacted Teeth
An impacted tooth can be detected by a dentist through the use of special x-rays like OPG (orthopantomography), IOPA (intra oralperiapical radiograph ) and occlusal view x-ray. The x-rays give a clear picture about the position of the tooth with respect to the other surrounding structures. It helps the dentist in planning the method of surgical removal.
Complications due to presence of Impacted Teeth
1. PERIODONTITIS
Erupted teeth that are adjacent to impacted teeth are predisposed to periodontal disease. Since the most difficult tooth surface to be cleaned is the distal surface of the last tooth, in the presence of an impacted tooth there is always gingival inflammation around the second molar that is invariably present . Even this minor amount of inflammation can provide bacterial access to a larger portion of the root surface that result in early formation of periodontitis compromising the tooth.
2. DAMAGE TO OTHER TEETH
If the wisdom teeth pushes against the second molar, it may damage the second molar or increase the risk of infection in that area. This pressure can also cause problems like crowding of the other teeth or require orthodontic treatment to straighten other teeth.
3. CYSTS
The wisdom tooth develops in a sac with in the jaw bone, teeth and nerves. Rarely, a tumor usually non-cancerous (benign) develops. This complication may require removal of tissue and bone.
4. DECAY
Partially impacted wisdom teeth appear to be at higher risk of tooth decay than other teeth. This probably occurs because wisdom teeth are harder to clean, food and bacteria get easily trapped between the gum and bacteria get easily trapped between the gum and a partially erupted tooth. Sometimes the adjacent tooth also can become decayed as food lodges between the two teeth and can produce dental decay.
5. PERICORONITIS
The difficulty in cleaning impacted, partially erupted wisdom teeth increases the risk of developing a painful, inflammatory gum condition called pericoronitis in that area.
Treatment of Impacted Teeth
Treatment of impacted teeth depends upon the tooth which is impacted and its location within the bone. If the tooth is an upper canine and in a favorable position then a surgical exposure of the tooth is done and by orthodontic treatment the tooth can be pulled back into its normal space . if the tooth is a third molar, it is usually indicated for surgical removal. Surgical removal of impacted teeth can be done under local anesthesia or under general anesthesia. Surgical removal of impacted teeth under local anesthesia is the most common method while general anesthesia is preferable for apprehensive patients and patients with multiple impacted teeth . The advantage is that multiple impacted teeth can be removed at one sitting.
Prevention of Impacted Teeth
Regular dental-check up will help your dentist to identify the presence of impacted teeth . Dental x-rays will be helpful to identify the position of the impacted tooth and in treatment planning. Earlier removal of the impacted teeth will help in preventing the possibility of future complications and damage to the adjacent tooth.