Many people associate the orthodontist with braces and retainers, but there’s another common dental issue that brings people to these specialists: impacted teeth. The term “impacted teeth” means teeth that haven’t erupted through the gum line and grown into their proper position.

What Are Impacted Teeth?

Impacted teeth refer to teeth that are unable to erupt through the gum line and grow into their proper position along the dental arch.[1] This can happen partially, meaning a tooth has broken through the gum but doesn’t fully emerge, or fully, meaning the tooth remains completely embedded under the gum or bone.

The most commonly impacted teeth are the third molars, also known as “wisdom teeth,” and the canines, particularly the upper (maxillary) canines.[2] “Impacted teeth” means that a tooth is “trapped” by gum tissue, bone, or other teeth.

While impacted teeth are a common dental problem, they can lead to other dental problems when left untreated.

Why Do Teeth Become Impacted?

Dental impaction can occur for several reasons:

• Lack of space: As humans evolved, our jaws have gotten smaller, but we still have the same number of teeth. This leaves the wisdom teeth without the room to grow properly, causing impaction.[3] About 90% of people have at least one impacted wisdom tooth.[4]
• Abnormal tooth growth: Teeth can grow at an angle, such as sideways, backward, or tilted, preventing them from erupting normally. This often occurs with wisdom teeth, but it can happen with the upper canines.
• Overcrowding: When the jaw doesn’t have enough space for all of your teeth, some may erupt in the wrong spot or stay beneath the gum. Unerupted teeth are often discovered during orthodontic evaluations.
• Delayed eruption or retained baby teeth: In children and teens, the primary (baby) teeth don’t fall out as they should, preventing the permanent tooth from growing in.[5]
• Genetics: If one or both of your parents had impacted teeth, you’re more likely to have similar problems.[6]

Are Impacted Teeth Painful?

Impacted teeth can be painful, but they’re not always. Some people can live with impacted teeth for years without experiencing any symptoms, while others may have discomfort, swelling, or infection, especially with impacted wisdom teeth.

Here are some common symptoms of impacted teeth:[7]

• Pain or swelling in the gums or jaw
• Difficulty opening the mouth fully
• Bad breath or an unpleasant taste
• Headaches or earaches
• Red, swollen, or bleeding gums in the area

If an unerupted tooth becomes infected or starts to crowd the other teeth, it can cause complications like damage to the neighboring teeth or cyst formation. Early detection and intervention are important to prevent other dental problems, particularly in the teenage years when the wisdom teeth begin to erupt.

Types of Impacted Teeth

There are several types of impacted teeth:[8]

• Soft tissue impaction: This means the tooth has emerged through the bone but not the gum.
• Partial bony impaction: Part of the tooth is stuck in the jawbone.
• Complete bony impaction: The entire tooth is still encased in the jawbone, making extraction more difficult.

What Happens If You Ignore an Impacted Tooth?

Ignoring an impacted tooth can have serious consequences for your oral health, including:

• Tooth decay
• Gum disease and infection
• Cysts or tumors around the tooth
• Root resorption of adjacent teeth
• Misalignment and crowding of other teeth

Even if you don’t have symptoms like pain, that doesn’t mean an impacted tooth is harmless. Complications can occur over time and often become more complex to treat.

Why Early Detection Matters

Identifying impacted teeth early, ideally during adolescence, can make treatment easier and more successful. Dental exams often involve a panoramic X-ray to evaluate how the teeth are developing below the surface, showing a dentist or orthodontist any unerupted teeth.

If an unerupted tooth is found during an exam, it’s easier to plan orthodontic treatment more precisely and reduce the need for invasive procedures later. For example, an impacted canine may be able to be guided into position with orthodontic treatment instead of extraction. Early detection also prevents any risks to the neighboring teeth or structures.

Impacted Wisdom Teeth vs. Other Teeth

Though third molars are the most commonly impacted teeth, they’re different from other types of dental impaction.

The wisdom teeth usually erupt between the ages of 17 and 25.[9] They’re often removed as a preventative measure, since these teeth have a high risk of complications like impaction or infection, and they’re rarely needed for functional chewing.

Conversely, the other teeth are necessary for biting, chewing, and guiding your bite. Impaction in the other teeth is often treated with orthodontics instead of removal – whenever possible – but early diagnosis offers the best outcomes.

Do Impacted Teeth Always Require Removal?

No, impacted teeth don’t always need to be removed. The treatment for impacted teeth depends on the type, location, and severity of the impaction, as well as the patient’s age and overall health.

If the impacted tooth isn’t causing any problems and is unlikely to in the future, it may be monitored with regular X-rays and exams. This is more common for partially impacted wisdom teeth that aren’t affecting neighboring teeth.

If the tooth is at high risk for infection, crowding, or damaging nearby teeth, it may need to be surgically removed. This is common with wisdom teeth that are fully impacted in the jaw. A surgical extraction is performed by an oral surgeon or dentist under local or general anesthesia to remove the tooth before it causes complications.

In some cases, such as impacted canines, orthodontics can help guide the tooth into its proper position. Orthodontists may work with an oral surgeon to expose the impacted tooth surgically and use brackets and appliances to slowly shift it into place. This may be used for teens and young adults, since their jawbones are still developing and more responsive to treatment.

Protect Your Smile

An impacted tooth is basically a tooth that’s “stuck” under the gums or in the bone and unable to erupt correctly. Though they may seem harmless and may not have any symptoms, untreated dental impaction can cause infection, pain, misalignment, and other oral health problems. Taking a proactive approach with regular dental exams to identify impacted teeth early is the best way to protect your smile and oral health.

Frequently Asked Questions About Impacted Teeth