Impacted Teeth: Symptoms, Diagnosis and Treatment

What Are Impacted Teeth? How To Diagnose, Treatment Methods, and More

An impacted tooth is a tooth that has not passed through the gum-line to grow into position on its own.

Instead, the tooth remains stuck – or “impacted” – in the gum tissue or bone. This can cause dental problems and other health concerns if left untreated.

There are several causes of impacted teeth, and a variety of methods for treating the issue. This guide will help you understand impacted teeth, why it’s important to treat this condition, and how expert orthodontic care can fix it.

Table of Contents:

What Are Impacted Teeth?

Impacted teeth occur when the teeth can’t grow in properly on their own; either something is obstructing their movement – such as the baby teeth not falling out – or there is not enough room for all the teeth. This causes the teeth to get stuck, sometimes barely pushing out from the gumline, or not visible at all under the gums.

Some people may have several impacted teeth, while others have only one. This depends on the causes of impacted teeth and how the teeth grow in. Alternatively, some people have impacted baby teeth, but their adult teeth grow in properly, or vice versa. It all depends on your unique teeth.

While impacted teeth may not cause pain or discomfort – you may not even know it’s there – it’s important to monitor it and, in some cases, to treat it. This can mean drawing it out to its proper position or extracting it.

Impacted Baby Teeth

When a baby tooth won’t fall out on its own, it may become submerged in the gum line or impacted and require intervention to remove it. It is uncommon, but in certain cases, these teeth can stubbornly refuse to fall out. This has a reciprocal effect on the adult teeth, which have no room to grow in properly and thus can either can get impacted themselves or grow in at a problematic angle.

An x-ray will help determine whether the baby teeth are causing improper growth of the adult teeth, and in some cases, the affected baby teeth will be removed early to leave room for the adult teeth. This is one of the reasons why early orthodontic intervention can be extremely useful: The American Association of Orthodontists recommends children see an orthodontist by age 7.

Impacted Wisdom Teeth

The most common impacted teeth condition is wisdom teeth, the last set of molars, which often don’t grow in due to lack of room in the mouth. Many people will have these impacted teeth removed in their teenage years or early twenties.

Impacted teeth don’t generally cause pain, but the condition should be carefully observed and treated if necessary. If left untreated over time, impacted teeth may cause dental damage, pain, or other health issues. If impacted third molars do not cause any issues or show any potential problems, dental professionals recommend careful observation to monitor any changes.

What Causes Impacted Teeth?

There are multiple causes of impacted teeth; an impacted tooth can be caused by one or multiple of the following factors.

Common Causes of Impacted Teeth:

The tooth has twisted or grown in at an angle that won’t fit, so it stops pushing through
Other teeth in the mouth have overcrowded the space for that tooth to grow in
The jaw is too small to fit more teeth, causing some to grow in and others to stop
The tooth is too big to fit in the space where it needs to grow
Genetic factors affecting the teeth or jaw
Accidental damage to the baby tooth affects the erupting adult tooth beneath, causing the adult tooth to become impacted

Since you grow two sets of teeth throughout your life, baby teeth and then adult teeth, there is a possibility of a tooth getting impacted and failing to grow in at either stage.

Baby Teeth Can Cause Impacted Adult Teeth

The causes of impacted teeth may be genetic – especially a mismatch between the size of your teeth and the size of your jaw – or could be caused by external factors, like premature loss of baby teeth, due to an accident or other mouth trauma.

Adult teeth can be impacted due to improper growth or delayed loss of baby teeth. This is common with the canine teeth (also called cuspid or upper eyeteeth). Delayed or premature loss of the first set of canines can stop the growth of adult canines, causing them to become impacted.

Causes of Impacted Wisdom Teeth

The wisdom teeth are the last teeth to grow in, erupting typically between 17-21 years of age. Wisdom teeth are vestigial: they were useful for our human ancestors, who had to chew much tougher raw foods than we do now, but we no longer need such robust molars. Over time, our jaws shrank – but wisdom teeth remain.

For some individuals, there will be enough room in the jaw for the wisdom teeth and they can grow in normally, but for many people, wisdom teeth get impacted without enough room to grow in.

Impacted teeth can cause pain or jaw damage. They also can stay impacted without any negative consequences – it depends on the specific case.

If they are impacted, your dentist or orthodontist will observe your wisdom teeth and determine whether they should be removed. Extraction of impacted third molars (wisdom teeth) requires oral surgery and can be a complex procedure. Therefore, observing the wisdom tooth impaction is important, since removal may not always be necessary. Ask your orthodontist for their professional counsel regarding your wisdom teeth.

What are the Signs of Impacted Teeth?

You may or may not be able to see the impacted tooth: sometimes, it is visible at the gum line, but stuck from growing in further. In other cases, it may be still entirely embedded in the gums, and you cannot see it.

X-rays help your orthodontist determine the position of the impacted teeth, even if you can’t see it in your mouth.

Other signs to look out for that may be evidence of an impacted tooth:

Bad breath
Bad taste in your mouth
Gum tenderness or pain
Swollen, red, or painful gums
Gaps in teeth
Headaches
Jaw aches
Pain when opening your mouth
Difficulty or pain when chewing, biting, or swallowing
Premature or delayed loss of baby teeth

If you have crowded teeth, it can be difficult to assess whether a tooth has grown in or not just by looking at your teeth: visiting an orthodontist is important since they can take x-rays to examine which teeth may not have grown in properly.

If you have any of these signs, consult a licensed, experienced orthodontist who can examine your teeth, take x-rays and diagnostic records, and assess whether there is a need for treatment.

Are Impacted Teeth Bad for the Health of Your Mouth?

It is important to treat impacted teeth because leaving them alone can have serious consequences for your other teeth, as well as your overall health.

Consequences of Impacted Teeth:

Cosmetic issues
Abscesses (pockets of infection)
Damage to the neighboring teeth
Tooth decay or loss
Bite or chewing problems
Jaw pain and headaches
Gum inflammation
Periodontal disease

It’s important to treat impacted teeth, either by extraction or with orthodontic treatment.

Visiting an orthodontist will allow a licensed professional to examine your teeth, using x-rays to see what’s below the gum-line, to establish whether certain teeth are impacted, and make a plan for treating them.

How to Treat Impacted Teeth

There are a variety of options for treating impacted teeth. Your orthodontist will do a thorough examination and recommend the correct course of action.

Treatment depends on various factors:

Whether the teeth are baby or adult teeth
Whether intervention can help them grow in properly
The nature or severity of the impacted condition.

Treating Impacted Baby Teeth

Treating impacted baby teeth is different than adult teeth because loss is inevitable: whether the impacted tooth is removed manually or not, the tooth needs to come out eventually for the adult teeth to grow.

For that reason, extraction is a common treatment for impacted baby teeth, but not always the solution. Your child’s dentist and orthodontist will work together to determine the best course of action for an impacted baby tooth.

When it comes to treating impacted baby teeth, the most important goal is always to minimize potential complications later on, resulting in more complex orthodontic interventions. Early treatment and consultation with an orthodontist can reduce the need for complex, expensive care later on.

Treating Impacted Adult Teeth

With impacted adult teeth, there are more factors to consider:

Is it possible to “rescue” the tooth, rather than extracting it?
Is there enough space for it to grow in, and can space be created?
What effect is the impacted tooth having on the other adult teeth?

Treating impacted teeth requires careful, precise interventions, and the supervision of a licensed, experienced orthodontist.

Extractions with Oral Surgery

Depending on the severity or placement of the impacted tooth, as well as the positioning of the rest of the teeth, the most effective treatment may be to simply extract the impacted tooth.

This requires oral surgery from a dedicated oral surgeon or dentist with extraction experience. Extractions will generally take place before beginning orthodontic care. If oral surgery is necessary, your dentist or orthodontist will give you a referral for the procedure. Oral surgery requires a referral from another dental professional.

Treating Impacted Teeth with Braces

There are many useful, effective, and safe interventions for impacted teeth using braces treatment.

Metal or ceramic braces may be used to treat an impacted tooth, under the supervision of an experienced orthodontist.

One such treatment method involves a simple surgery to open the gum and expose a small piece of the impacted tooth. A small ring is then affixed to the tooth, which attaches to the braces wire with a small chain. The consistent tension of the chain slowly coaxes the tooth out of its impacted position, into place with the other teeth.

Once the tooth has come down, traditional braces treatment can be used to adjust it into proper alignment.

Treating Impacted Teeth with Invisalign Clear Aligners

Whether Invisalign treatment can help extrude impacted teeth depends on the severity of the diagnosis. In certain cases, Invisalign aligners can help align impacted teeth – but generally, this condition requires other treatment first, before moving on to Invisalign with the supervision of an experienced orthodontist.

It is possible to draw out an impacted tooth with Invisalign aligners by utilizing special metal attachments and specific techniques. Make sure to choose an experienced, qualified Invisalign provider, not an off-brand clear aligner provider or DIY at-home kits.

After the impacted teeth have been brought down, the metal attachments can be removed and treatment continued with traditional Invisalign clear aligners, for a discreet and effective treatment to straighten all the teeth into their correct positions.

If extractions are necessary, this will take place before the Invisalign treatment begins.

If you are interested in Invisalign clear aligners and have impacted teeth, consult with a licensed, experienced orthodontist about potential solutions.

Do not seek treatment from a teledentist using at-home, mail-order aligners: these companies may approve you for treatment without ever having a comprehensive picture of your condition, which can cause serious, permanent damage to your teeth and mouth.

Retainers

Retainers aren’t used to extrude or fix an impacted tooth, but they will be used to keep your teeth in place once the results have been achieved.

It’s important to wear your retainers as instructed by your orthodontist, to ensure that your smile stays healthy and shining for years to come!

Impacted Teeth: Before & After Orthodontic Treatment

Stella, 30 Years Old, with Upper Right Canine: Before and After Invisalign Treatment

Female Years Old with Impacted Teeth Before and After Invisalign Treatment

Leah, 16 Years Old, with Impacted Teeth: Before and After Treatment

Female Years Old with Impacted Teeth Before and After Treatment

Yuliya, 29 Years Old, with Upper Left Canine: Before and After Treatment with Braces

Female Years Old with Impacted Teeth Before and After Treatment with Braces

Frequently Asked Questions About Impacted Teeth

1Do I Have to Treat Impacted Teeth?

It is important to treat impacted teeth. Leaving them impacted can cause a variety of dental issues, including higher potential for cavities or abscess, gum pain, inflammation, or swelling, periodontal decay, and gum infection, as well as jaw or tooth pain, trouble chewing, biting, or swallowing, and headaches. The impacted tooth does not necessarily need to be removed: orthodontic intervention can bring the tooth down into its correct position.
2Do Impacted Teeth Need to Get Removed?

Not necessarily. Carefully supervised orthodontic care can bring an impacted tooth down into its correct position, without extraction/removal. Impacted baby teeth may be removed since they will fall out anyway, but a licensed orthodontist will assess your adult impacted teeth to see if there is a way to save them.

If you have too many teeth, causing certain teeth to be impacted, the extra teeth may be removed to make room for the right number of teeth without overcrowding.
3Will an Impacted Baby Tooth Grow in Eventually?

It depends. Early orthodontic care is critical to ensuring the baby teeth fall out properly and leave the right amount of room for the adult teeth to come in properly. An impacted baby tooth may get stuck and, due to genetic issues or some external factor, fail to grow in properly or fall out in time for the adult tooth to follow behind it.

A situation like that may require orthodontic intervention or extraction of the baby tooth, to make sure the adult teeth grow in healthily, properly, and safely.
4What Are Impacted Baby Teeth?

Impacted baby teeth occur when a tooth in the first set of teeth fails to grow in properly or fails to fall out. Generally, baby teeth do not often get impacted but most of the time get “submerged” or ankylosed, causing the adult canines to get stuck behind them.

Baby molars sometimes get impacted as well, requiring extraction. The most common reason for a baby tooth to get impacted is that a child is missing an adult tooth, due to genetic factors, which are supposed to push baby teeth out. When that tooth doesn’t exist, it can’t push the baby molar out, and that tooth gets impacted, requiring extraction.
5What Are Impacted Wisdom Teeth?

Wisdom teeth are the last set of molars to appear, typically growing in around 17-21 years of age. Due to evolutionary changes in human teeth, wisdom teeth are no longer necessary, and most people’s jaws are too small to make room for them.

This can cause the wisdom teeth to get impacted as they attempt to grow in, or to push and crowd the other teeth as they attempt to erupt. For that reason, many teenagers or young adults will have some or all their wisdom teeth removed.
6Do You Have to Remove Impacted Baby Teeth?

It depends on the specific diagnosis. Whatever intervention – whether early orthodontic care, removal/extraction, or a “wait and see” method – is chosen to minimize future complications, and try to ensure the best possible results when the adult teeth grow in. If an impacted baby tooth is not falling out and causing disruption to the adult tooth beneath it, it may need to be removed.
7What Happens if You Don’t Remove Impacted Teeth?

Impacted teeth that are not treated can have significant consequences for your teeth and gums. Leaving them in their impacted positions can cause jaw pain and headaches, gum inflammation, periodontal issues, cavities or dental caries, infection abscesses, and dental cysts. They can also cause damage to their neighboring teeth, causing crowding or the absorption of bone of other teeth.

People with impacted teeth may experience bad breath or a sour taste in their mouth. Impacted teeth can be extruded, rather than removed, to bring them down to their proper position – but they should be addressed by a licensed orthodontist as soon as possible.
8How Long Does it Take to Treat an Impacted Tooth?

Treatment times depend on the dental condition, the complexity of treatment, and the orthodontic provider you choose. Make sure to choose an experienced, licensed orthodontist to assess the condition and determine the proper diagnosis.

Removal of an impacted tooth can be done with a simple surgery – but further orthodontic care may be necessary to achieve straight teeth and a healthy smile. Bringing an impacted tooth into its correct position (and properly aligning the rest of the teeth) will take longer – anywhere from 6 months to 2 years.
9Can Braces Treat an Impacted Tooth?

Yes, braces are an extremely effective method for treating an impacted tooth. A special procedure allows the orthodontist to carefully bring the tooth down, using a small chain that uses tension to lower the tooth into its proper position. Once the tooth has been brought down, braces can be used to properly align all of the teeth, to achieve straight teeth and a beautiful smile!
10Can Invisalign Treat an Impacted Tooth?

Treatment for an impacted tooth is generally difficult with Invisalign alone: another intervention is usually necessary to extrude the tooth, followed by Invisalign to align the teeth into their correct positions. Invisalign can be used to extrude impacted teeth, under the supervision of an experienced and highly-skilled practitioner. To do this, your doctor will apply the downward tension necessary to pull a tooth down from the gun line, using adjunctive methods like buttons or attachments.

If you’re interested in Invisalign and have an impacted tooth, consult an experienced Invisalign provider orthodontist to find out how you can achieve straight teeth using clear aligners! Search Invisalign for a local provider near you with the highest credentials for Invisalign experience: Diamond Plus or Diamond providers are the most experienced with Invisalign.
11How is an Impacted Tooth Treated?

The treatment for an impacted tooth depends on the specific diagnosis, and whether the tooth is a baby tooth or an adult tooth. Extraction/removal may the best option – particularly with a baby tooth that needs to fall out in order to make room for the adult tooth – but in many cases, impacted teeth can be treated with orthodontic care to bring down into their correct position, and then align the teeth for a straight, healthy smile.

Your orthodontist will take detailed x-rays to determine exactly what’s happening with the impacted tooth, and determine the best treatment to achieve a healthy, happy smile.
12What Does an Impacted Tooth Look Like?

An impacted tooth may be hard to see – it could be hidden entirely under the gumline. Partly exposed impacted teeth may look like they are actually sinking into the gums. Other signs of an impacted tooth include: gum bleeding or redness, jaw pain or headaches, decay to neighboring teeth, bad breath or a sour taste in the mouth, or inflammation in the mouth.
13Do You Need Braces for an Impacted Canine?

It depends on the diagnosis. Braces can be very effective for correcting impacted canines. Your orthodontist will use specific treatment methods to bring the impacted canine down slowly and safely into its correct position. In certain cases, removal of teeth may be necessary to make room for the teeth in a healthy smile with straight teeth. Braces are very effective for treating impacted canines.
14Are Impacted Canines Common?

Impacted canines are not very common – orthodontic experts estimate they affect about 2% of the population – but they are a relatively common concern for people seeking orthodontic treatment. Orthodontists are extremely skilled and experienced with treating impacted canines, and will use x-rays and comprehensive diagnosis to determine how best to fix your impacted canines.
15How Much Does it Cost to Fix an Impacted Tooth with Invisalign?

Invisalign costs vary from $2,650 to $9,000. However, Invisalign alone may not be fully effective in correcting an impacted tooth. Some additional buttons or attachments may also be necessary, which depending on your provider may or may not be included in the price. Talk to your orthodontist about how to treat impacted teeth with Invisalign.
16Can You Die from an Impacted Tooth?

It is extremely rare, but infection stemming from an impacted tooth can spread to the brain, and lead to very severe illness or even death. Infection anywhere in the body needs to be addressed quickly, and any infection near the brain should be taken very seriously. Impacted teeth are likely sites for inflammation, swelling, and possible infection, so it’s very important to treat an impacted tooth as soon as possible.
17Can Impacted Canines Cause Headaches?

Yes, impacted teeth, including canines, can cause headaches, although this is rare. Impacted teeth occur when the tooth is stuck and unable to grow in. It exerts pressure on your jaw and facial bones as it tries to erupt into its position, which can lead to jaw pain, gum tenderness or inflammation, and headaches.

Some impacted teeth don’t cause any discomfort and can be left alone, although it’s important to have your orthodontist monitor them carefully for any changes.