Impacted Teeth

Which Teeth Are Most Commonly Affected

• Wisdom Teeth

  The third molars — commonly called wisdom teeth — are the most frequently impacted teeth. They are the last teeth to develop, typically between the ages of 17 and 25, and often arrive when there is no longer enough room in the jaw to accommodate them.

• Canines

  The upper canines — the pointed teeth on either side of the front four teeth — are the second most commonly impacted. Unlike wisdom teeth, impacted canines can often be guided into their correct position with orthodontic treatment, making early detection particularly important.

• Other Teeth

  In less common cases, premolars or other teeth may become impacted, particularly in patients with significant crowding or those who have had teeth extracted in childhood.

What Causes a Tooth to Become Impacted

• Insufficient Space in the Jaw

  The most common reason a tooth becomes impacted is that the jaw does not have enough room for it to emerge fully. This is particularly relevant for wisdom teeth, which develop last and often find the arch already occupied.

• Abnormal Growth Angle

  A tooth may begin growing at an angle — toward the adjacent tooth, away from it, horizontally, or straight downward into the jaw. This prevents it from following the normal eruption path.

• Retained Baby Teeth

  When a baby tooth does not fall out at the appropriate time, it can block the permanent tooth beneath it from emerging. This is one reason timely pediatric dental monitoring matters.

• Dense Bone or Thick Gum Tissue

  In some cases, the bone or gum tissue overlying the tooth is too dense for the tooth to push through on its own.

• Genetics

  Jaw size, tooth size, and eruption patterns are influenced by genetics. A patient whose parents experienced impaction may be at higher risk.

Symptoms and Signs to Watch For

Symptoms vary depending on whether the impacted tooth is fully submerged or partially erupted. An impacted tooth does not always cause immediate pain — some are discovered only on a routine X-ray.

When symptoms are present, they may include:

• Pain or pressure at the back of the jaw or along the gumline
• Swollen, red, or tender gum tissue around the affected area
• Difficulty opening the mouth fully
• A bad taste in the mouth or persistent bad breath, particularly if the area is infected
• Headaches or jaw aches that seem to have no obvious cause
• Visible crowding or shifting of nearby teeth

In children and teenagers, an impacted canine is sometimes first noticed when the baby canine falls out but no adult tooth emerges — or when the smile looks uneven.

Why Impacted Teeth Should Not Be Left Untreated

An impacted tooth that is not causing symptoms may not require immediate treatment, but it should always be monitored. When left unmanaged, impacted teeth can lead to a range of complications.

• Infection and Pericoronitis

  A partially erupted tooth creates an opening in the gum where bacteria can accumulate. This can lead to pericoronitis — an infection of the soft tissue around the tooth — causing swelling, pain, and in severe cases, difficulty swallowing or opening the mouth.

• Damage to Adjacent Teeth

  A tooth growing at an angle places pressure on the roots of neighboring teeth. Over time, this can cause root resorption — where the root of the adjacent tooth is gradually absorbed — or accelerate decay in areas that become difficult to clean.

• Cyst Formation

  The sac of tissue surrounding an unerupted tooth can fill with fluid and develop into a dentigerous cyst. If left untreated, cysts can enlarge, damage surrounding bone, and require more complex surgical management.

• Crowding and Bite Problems

  Pressure from an impacted tooth can shift adjacent teeth out of alignment, affecting the bite and potentially undoing previous orthodontic treatment.

How Impacted Teeth Are Treated

Treatment depends on which tooth is affected, the degree of impaction, the patient's age, and whether symptoms are present. It is determined following a clinical examination and imaging, typically a dental panoramic X-ray or CBCT scan.

• Monitoring

  For fully impacted teeth that are asymptomatic and not causing damage to adjacent structures, a watch-and-wait approach with regular X-rays may be appropriate — particularly in older patients where the risks of surgery outweigh the benefits.

• Extraction

  Extraction is the most common treatment for impacted wisdom teeth and is recommended when the tooth is causing pain, infection, or damage to surrounding structures. For a full walkthrough of what the procedure involves, surgical options, and what to expect during recovery, see Impacted Tooth Extraction.

• Surgical Exposure and Orthodontic Guidance

  For impacted canines — and occasionally other permanent teeth — extraction is not the preferred outcome. Instead, a Specialist Oral Surgeon exposes the tooth surgically, and a Specialist Orthodontist uses a fixed appliance to gradually guide it into its correct position in the arch. This approach preserves the natural tooth and is most effective when identified early, ideally before the age of 14.

• Operculectomy

  When a tooth is partially erupted and obstructed by a flap of gum tissue (called an operculum), a minor procedure to remove this tissue may be sufficient to allow the tooth to emerge on its own.