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The Impacted Tooth Blog

The Impacted Tooth Blog

Understanding What An Impacted Tooth Is

When your dentist or orthodontist tells you that you have an impacted tooth, what they are really telling you is that you have a tooth that is not going to come into your mouth on its own. In other words, impacted means stuck. The word stuck is much less dramatic than the word impacted but it’s a less scary and better way to understand what’s really going on.

Types of Impacted Teeth and Reasons for Impacted Teeth

People are most familiar with impacted wisdom teeth. The wisdom teeth are usually the last teeth in the mouth to come in and are actually the third set of molars. These teeth are very often impacted (stuck) because there is not enough room in the mouth for them to come in. That is, the distance between the second molar and the back of the jaw is not wide enough for the tooth to emerge. Therefore, it is wedged between the second molar and the back of the jaw. See the x-ray and drawing below.

X-Ray of a 14 year old patient who has 4 impacted upper teeth (2 premolars and 2 canines). She also has late developing lower premolars. The lower premolars are not considered to be impacted because they have not finished root development. Note the differences in The amount of root development of the lower un-erupted teeth. The one on the left will have to be managed carefully in order to prevent from becoming impacted.

X-ray showing impacted lower premolar. This tooth was very late in developing and also developed sideways. Patient and parents elected to complete braces while in middle school and address this tooth at a later date.

 

 

 

 

Oftentimes, impacted wisdom teeth appear to be “pushing” on the teeth in front of them so people assume that overtime wisdom teeth will push the remaining teeth into more crooked positions. This is actually not true because the wisdom teeth do not push with enough force to move the other teeth.

It is true that people’s teeth will move over time, but it is not because of the wisdom teeth. We know this because people who never had wisdom teeth still experience tooth movement later in life, so clearly it is something besides the wisdom teeth causing this.

Dentists and orthodontists generally recommend that wisdom teeth be removed when patients are young and healthy because wisdom teeth that are left in place, whether they are impacted or not, are generally not used in chewing and tend to create problems with infection and decay. Therefore, Dr. John McDonald almost always recommends that the wisdom teeth on his patients are removed before they leave high school as a preventive measure.

Impacted Teeth Other Than Wisdom Teeth

Any tooth in the mouth can become impacted although it is more common in some teeth than in others.

Upper Canine Teeth

The most common tooth other than wisdom teeth to be impacted are the upper canine teeth. there are several reasons for this. The most common reason is that there just isn’t enough room for the tooth to come in. Because the upper canine tooth is usually the last one to come in, oftentimes other teeth have “stolen” the space that the canine would have used. Think of musical chairs and the canine is the one that gets squeezed out.

When upper canines are impacted, they can be impacted in the roof of the mouth or they can be impacted or stuck right in the middle of the jaw between two teeth. When canines are impacted in the palette, they are more difficult to move into the proper place because they are so far out of position. Canines that are stuck between two other teeth tend to be much easier because they are closer to their final position and tend to be pointed in the right direction.

Impacted Premolars and Incisors

As mentioned before, any tooth can be impacted but it is much less common to see impactions in other areas. The main reasons for impacted teeth in these areas usually involve teeth that are growing in the wrong direction or baby teeth that just don’t seem to want to dissolve in a normal fashion. See the X-ray below.

Impacted lower 3rd molars (wisdom teeth). They may appear to be “pushing” on the rest of the teeth, they actually do not exert any force that can cause teeth to become crowded.

 

Frequently Asked Questions

Can impacted teeth be prevented?

Absolutely! Impacted teeth can be prevented, and preventing impacted teeth is one of the biggest reasons that orthodontists prefer to see children at a young age. Orthodontists can see when a tooth is heading towards becoming impacted and oftentimes there are simple steps that can be done to prevent the impaction from occurring.

What can parents do to prevent impacted teeth?

The best thing is to see an orthodontist when your child turns seven. This gives the orthodontist the greatest chance of intercepting a tooth that is on its way to impaction. Visibly crowded teeth, or baby teeth that seem to be loose for a long time before coming out, are also signs that your child has a better chance of having an impaction problem, and your child will have a greater possibility of having an impacted or stuck tooth.

There is also a genetic component to impacted teeth so they tend to run in families. Ask your spouse if they are aware of a history of impacted teeth in their family.

In the end, the best thing you can do for your child is to get them to the orthodontist early. This always makes treatment less invasive and easier on the child. Call Dr. McDonald’s office at (503) 585-5400 for an evaluation or visit our website for our new virtual online consultations.