What is an Impacted Tooth/Teeth?

An Impacted tooth/teeth refers to permanent tooth/teeth that have failed to come through at the appropriate age. The teeth usually affected are the permanent canine teeth, and the permanent premolar teeth. These are normally present inside the mouth by 10 to 13 years of age.

If left untreated it may cause aesthetic, function issues and damage to surrounding teeth. If impacted teeth are found early, preventative treatment may allow the tooth to erupt on its own. However, if it is severe or tooth development is no longer favourable, minor surgery may be indicated.

Why do impacted teeth need to be corrected?

If left untreated it may cause permanent damage to roots of adjacent adult teeth. If an adult tooth is impacted it means the baby tooth may still remain. Due to the smaller size of the baby tooth it typically results in reduced aesthetics. Eventually, the baby tooth can loosen and fall out spontaneously, leaving an unfilled large gap.

Minor surgery may be required if impacted teeth are left untreated till a later age. It may lead to an increased risk of complications including the risk of non movement (ankylosis) of the impacted tooth, due to its prolonged impaction. 

If the impacted tooth does erupt by itself, it can erupt high against the gum, leaving an inflamed gum that can be hard to correct, even through successful orthodontic treatment with braces.

What are the treatment options?

• In children: Space maintainer may be sufficient for the impacted tooth to erupt by itself. Occasionally if there is marked crowding and a narrow upper jaw, a custom made expander may be required to regain space.
• In teens: If the impacted permanent tooth is moderate to severe, surgical exposure of the impacted tooth is often required. This is where a chain is attached to the impacted tooth by an oral surgeon. The chain is then attached to the braces by the orthodontist, who uses it to guide the impacted tooth into the correct position. Upper and lower braces are often required to straighten the impacted tooth.
• In adults: Orthodontic positioning of the impacted tooth normally achieved through upper and lower braces.

Reminder:

• Depending on the complexity, severity, and age of diagnosis of the impacted tooth there are many different treatment options.
• If the impaction position is very severe, often an elective decision will be made to keep either keep the impacted tooth and straighten the teeth around it OR remove the impacted tooth and straighten the overlying teeth with braces.