Impacted Teeth: Causes, Symptoms, and Treatment
In dental practice, situations arise where a fully formed tooth remains hidden within the jawbone or is located directly under soft tissue. This phenomenon is called retention. This condition requires medical supervision, as a hidden crown can lead to a number of serious dental health problems. Therefore, timely treatment of an impacted tooth helps avoid adverse consequences, including severe inflammatory processes.
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Which teeth are most often impacted?
Eights are the last teeth to erupt. The modern human jaw has shrunk slightly during evolution due to changes in diet. As a result, impacted wisdom teeth are much more common than other teeth, simply because they lack the space to emerge. Wisdom teeth remain subgingivally, causing discomfort.
Impacted Canines and Other Teeth
Upper canines are also prone to impaction. They begin to grow much later than incisors, so they often become lodged in the maxillary bone. This pathology also affects premolars and lower lateral incisors.
Semi-impacted and Dystopic Teeth
There are situations where the crown only partially emerges from the mucosal surface. Such a tooth is called a semi-impacted tooth. In some cases, the crown grows at an angle, is significantly offset from the central axis, and may also be rotated around itself. This is a dystopic tooth. This pathology can be combined with other pathologies, significantly complicating the overall picture. Semi-retention and dystopia occur simultaneously, which is considered a complex case in dental practice and requires surgical treatment.
Causes of retention
The development of the dental system is a complex process, and it doesn't always proceed smoothly. Sometimes a tooth stops advancing during the growth stage and remains trapped within the jaw. This is usually due to specific factors that prevent it from penetrating dense tissue and finding its proper position in the dental arch.
Lack of Space
Most often, the problem is related to a lack of space in the jaw. When the jaw is narrow and the teeth are crowded, the tooth simply doesn't have enough room to erupt normally.
Abnormal Position of the Teeth
Sometimes the teeth initially grow at an angle. Then the tooth failed to erupt not because of poor growth, but because of incorrect direction.
Hereditary and Orthodontic Factors
The shape of the jaws, the timing of the replacement of primary teeth, their early loss, and bite anomalies are all significant. In many cases, multiple factors are at play.
Diagnostics
Diagnostics proceeds in the following sequence.
Dental examination
The dentist evaluates the gums, swelling, and the position of the teeth in the row.
X-ray diagnostics
Diagnostics usually begins with an X-ray or orthopantomogram. This examination shows the location of the crown, the position of the roots, and the surrounding structures.
CBCT for complex tooth positions
If the problematic tooth is located deep, has a nearby nerve, or has an atypical root shape, CBCT is prescribed. Tomography helps plan the procedure more accurately and safely.
General information
When treatment is needed
Observation is acceptable if the tooth does not cause pain, does not damage adjacent tissue, and does not pose a high risk based on imaging.
When orthodontic extrusion is indicated
If the tooth is functionally important and can be realistically brought into alignment, the dentist may choose extrusion. This approach is most often used for canines.
When is removal of an impacted tooth recommended?
Indications include inflammation, cysts, dystopia, root pressure, and repeated episodes of pain. In such cases, treatment of an impacted tooth often involves surgery.
To slow down the problem, it's important to visit your dentist regularly. Scheduled visits prevent pain and complications. Monitoring is crucial, especially during the period when canines and wisdom teeth are erupting.
Why is it important to monitor tooth eruption?
If an unerupted tooth is left unattended and unexamined, the patient runs a high risk of inflammation and damage to adjacent tissues. Therefore, a scheduled visit to the dentist is essential. The dentist will order an X-ray and, if necessary, perform a CBCT scan. Afterward, the dentist will assess the situation and prescribe the necessary treatment. If necessary, the patient will be referred to a dental surgeon for a consultation.
Frequently Asked Questions
What are the characteristics of a problem tooth?
Should it be removed?
What's the difference between an impacted tooth and a dystopic tooth?
How long does recovery take after an extraction?
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Symptoms of an impacted tooth
Sometimes a problem is discovered accidentally on an x-ray, when the person isn't complaining of anything at all. There's no pain, and the gums appear normal, but such a finding still requires follow-up by a doctor.
Pain, swelling, and inflammation of the gums
An impacted tooth often manifests itself with pain when chewing, swelling, redness of the gums, and bad breath. If the tooth has only partially erupted and is covered by mucous membrane, inflammation often develops in the so-called hood. In such cases, there is a high risk of pericoronitis, especially if it's a wisdom tooth. Warming this area or trying to treat it yourself is dangerous.
Pressure on adjacent teeth and malocclusion
An incorrectly positioned crown can cause pressure on adjacent teeth, displacement of teeth, and changes in the bite. Sometimes a feeling of pressure in the jaw is felt, and sometimes changes are only visible on x-ray.
Signs that require immediate consultation:
Soft tissue inflammation and pericoronitis
This hood creates conditions where plaque and bacteria can easily accumulate. Because of this, inflammation in this area often returns, and this is the main risk.
Caries of the adjacent tooth and root damage
If the crown rests against a molar, the contact surface is damaged, and the dentist may even notice caries, as well as tissue irritation or root resorption. Such complications of an impacted tooth can remain latent for a long time, and the problem can only be identified during a consultation with a dentist.
Cysts, displacement, and other complications
A cyst often forms around the crown, which can also lead to displacement, chronic inflammation, and even more complex problems, which also require complex treatment.