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Impacted Teeth and Treatment Approaches

What You Need to Know

Oral and dental health is an integral part of overall body health. One of the issues we frequently encounter in dental clinics and that our patients are most curious about is impacted teeth and the clinical conditions they can cause. In this informative article, we will examine what impacted teeth are, why they occur, and how they are treated in modern dentistry.

What is an Impacted Tooth?

Teeth that fail to emerge visibly in the mouth at their expected time due to bone or soft tissue barriers and remain within the jawbone are called impacted teeth. While the most common impacted teeth in the mouth are third molars (wisdom teeth), canine teeth (eyeteeth) and premolars can also frequently remain impacted.

Why Do Teeth Remain Impacted?

Many genetic and environmental factors play a role in a tooth remaining impacted. The most common causes include:

• Narrowness of the Dental Arch: Along with changes in dietary habits during evolutionary processes, human jaw structure has shrunk, but tooth sizes have not reduced at the same rate. This leads to space deficiency and teeth failing to erupt.
• Position of Adjacent Teeth: Incorrect inclination or positioning of the neighboring tooth can block the path of the erupting tooth.
• Genetic Factors: Familial predispositions are an important factor in jaw and tooth size mismatches.
• Early Primary Tooth Loss: Premature loss of baby teeth can cause the loss of guidance path for permanent teeth or cause neighboring teeth to shift into this space, blocking the path.

What Problems Can Impacted Teeth Cause?

There is no rule that every impacted tooth will immediately cause problems; however, fully or partially impacted teeth may lay the groundwork for these clinical problems over time:

1. Pericoronitis (Gum Tissue Infection): Food particles accumulate in gum pockets around partially impacted wisdom teeth in particular. Since brushing this area is difficult, bacteria multiply easily, leading to infections accompanied by pain, swelling, and restricted mouth opening (trismus).
2. Caries and Root Resorption in Adjacent Teeth: An impacted tooth can exert pressure on the healthy tooth in front, causing root resorption or creating an uncleanable area leading to decay.
3. Cyst and Tumor Formation: The tissue surrounding the impacted tooth, called the follicle, can expand over time, albeit rarely, turning into pathological formations such as cysts or tumors within the jawbone. This leads to bone destruction.
4. Orthodontic Problems: Lack of space in the dental arch and eruption pressure from impacted teeth can cause crowding in existing dental alignment.

Diagnosis and Treatment Methods

The diagnosis of impacted teeth is made through a detailed intraoral examination and panoramic X-ray (orthopantomography) evaluation performed by your dentist. In cases where bone relationships are critical or show close proximity to anatomical structures (nerve canals, sinus cavities), your dentist evaluates the region millimetrically using Three-Dimensional Cone Beam Computed Tomography (CBCT).

Treatment Options:

• Periodic Monitoring: If the tooth is completely bone-impacted, does not cause any pathology (cysts, etc.), and does not harm neighboring teeth, it can be monitored with periodic X-rays.
• Surgical Extraction: Impacted teeth that carry infection risk, cause decay or cyst formation, or impede orthodontic treatment must be surgically extracted under local anesthesia in sterile clinical conditions. Thanks to modern surgical techniques, these procedures are performed comfortably and painlessly.
• Forced Eruption (Orthodontic-Surgical Combination): Impacted canines, which carry great aesthetic and functional importance, can be exposed surgically and pulled into their proper places in the mouth using orthodontic wires.

In our Faculty Clinics, diagnosis and surgical treatment of impacted teeth are safely performed with our expert academic staff and modern technological infrastructure. We wish you healthy smiles.

Assistant Professor Ömer Can MANAV

Yozgat Bozok University

Faculty of Dentistry

Department of Oral and Maxillofacial Surgery