Impacted Tooth and Treatment Methods
What is an Impacted Tooth?
Impacted teeth are a common dental problem. An impacted tooth is simply a tooth that has not erupted into the mouth when it is time to erupt, and remains impacted in the jawbone. Teeth can become impacted when they try to erupt at an angle or when another tooth moves into the space it needs. An impacted tooth can damage the root or crown of surrounding teeth. If the damage is severe and left untreated, the impacted tooth can cause the neighboring tooth to wobble and be lost.
Almost every tooth in our mouth can become impacted. The most common impacted teeth are wisdom teeth, upper canines, lower canines and lower/upper premolars. The treatment for impacted wisdom teeth is usually surgical removal. Because wisdom teeth often do not participate in function and can cause various problems such as infection, pain and caries in neighboring teeth.
Classification
Impacted teeth can sometimes be partially impacted or fully impacted. Partially impacted teeth have erupted into the oral cavity partially, whereas fully impacted teeth are completely within the bone.
More than one tooth may be impacted. The most common impacted teeth treated by orthodontists are the upper permanent canines. Impacted canines may be located in the palate, they can push through the cheek/lip, or even seriously damage the surrounding teeth.
Classification of Impacted Teeth
Different classifications have been proposed for impacted teeth. You can read the article Frequency of impacted teeth and categorization of impacted canines: A retrospective radiographic study using orthopantomograms published in the European Journal of Dentistry in 2017.
Impacted teeth can be classified according to the angle of the tooth as follows:
- Partially erupted tooth: A tooth is classified as partially erupted when it fails to fully emerge from the gum, usually due to its angle and proximity to another tooth.
- Angularly impacted tooth: As the name suggests, in this type of impaction, the tooth moves at an angle within the bone and therefore cannot erupt.
- Vertical impaction: Occurs when a tooth erupts at a right angle but is too close to the adjacent tooth.
- Horizontal impaction: Occurs when a tooth tries to erupt at a horizontal angle and risks damaging a neighboring tooth.
Reasons for Impacted Teeth
There are many reasons why teeth remain impacted. Most of the time, the early loss of baby teeth causes the neighboring teeth to move into the gap and block the way for the tooth that will come from below, causing the tooth to remain impacted. Therefore, when a baby tooth is lost early, a ‘space maintainer’ must be made to protect the gap of the tooth. Other reasons are ankylosis, which is a condition in which the tooth is fused to the bone, and ankylosed teeth cannot be moved. In addition to these, factors such as trauma, infection, and genetics can cause the tooth to remain impacted.
How Do You Know If Your Tooth Is Impacted?
Many people are unaware that they have an impacted tooth until they visit the dentist. An examination or x-ray can confirm that the tooth is impacted.
Sometimes, there may be pain or swelling due to an impacted tooth. Headaches or limited mouth opening may also occur.
How Does Orthodontics Help Impacted Teeth?
Orthodontic treatment can resolve a number of dental and health issues, including impacted teeth.
Treatment Methods for Impacted Teeth
If impacted wisdom teeth cause problems, their treatment is extraction. Other impacted teeth can be erupted in the oral environment with orthodontic treatment, taking into account the patient’s aesthetic and functional expectations, the position of the tooth, and the patient’s general health. The treatment for the eruption of impacted teeth is performed similarly to other routine orthodontic treatments. At a certain stage of the treatment, the impacted tooth is surgically opened and a small ‘button’ is glued onto the tooth to which we can apply force to erupt it. After the surgery, the tooth is attempted to be erupted by applying light and continuous forces to the tooth. You can review our Orthodontic Treatments article for more information about braces treatments.
If, as a result of detailed examination, it is determined that the tooth is in a position that cannot be erupted, the impacted tooth can be extracted or left in place, depending on the situation. After the impacted tooth is erpted in the oral environment, you can use it with peace of mind like your other teeth 🙂
The impacted tooth eruption treatment I explained above is usually performed on impacted canine teeth. Because the most common percentage of impaction after wisdom teeth belongs to canine teeth and canine teeth are the most important teeth in the mouth, both functionally and aesthetically.
Let’s talk a little bit about canine teeth and impaction. Canine teeth in our upper jaw normally erupt around the age of 13. Canine teeth are the last permanent teeth to erupt in the mouth. Therefore, it is necessary to protect their place, that is, the baby tooth that will replace them should not be lost early. Even if they are lost, a space maintainer must be made. If the erupting canine tooth cannot find a place, it will remain impacted.
Impacted teeth usually respond well to treatment if their positions are evaluated well. Remember that treatment may fail, although it is unlikely. It is impossible to erupt impacted teeth in cases of ankylosis (the condition in which the tooth is fused to the bone). Because ankylosed teeth cannot be moved. Ankylosis diagnosis is best determined by applying movements to the impacted teeth with braces. The risk of ankylosis of these impacted canine teeth increases as the person ages.
Unfortunately, it is impossible to determine in advance whether a tooth is ankylosed or not.
Early Treatment
A dentist or orthodontist can detect an impacted canine tooth at an early age. Treatment can reduce the risk of the tooth remaining impacted. A baby tooth or another permanent tooth may need to be extracted to give a permanent tooth a chance to erupt.
The earlier an impacted tooth is diagnosed, the better the chance of resolving the issue without damaging (or losing) the tooth or surrounding teeth.
Sometimes impacted teeth cannot be treated with orthodontic treatment. Sometimes, considering factors such as the patient’s age, tooth position, difficulty of treatment and cost, the treatment of an impacted tooth may be abandoned.
Erken Tanı Önemlidir
Children should definitely be examined by an orthodontist starting at the age of seven. Some problems can be detected at an early age and easily solved. Panoramic X-rays should definitely be taken around the age of seven and the eruption directions of the teeth should be evaluated. Sometimes, even an extra tooth that forms on the way to the eruption of the canine tooth can cause the canine tooth to remain impacted.
