Understanding Impacted Teeth and When to Extract

added on: May 10, 2016

As teeth descend through the gums, most of them make it into the awaiting open gap without a problem. If a tooth cannot fit in the given space, however, it may start pushing the adjacent teeth to the side or become impacted. This situation is common while wisdom teeth come in during the early teen or young adult years. The human jawbone has decreased in size over the years, as our diets have evolved over the past several thousand years. As a result, wisdom teeth may either push through the gums crooked or may not have enough room to grow in at all.

When a tooth becomes impacted, it may cause an immense amount of pain until the problem is rectified. The impacted tooth can also cause a serious infection to develop below the gum line – where it might spread to the jawbone, bloodstream, or brain. Since your body cannot generally resolve this problem on its own, you may need to see a dentist to relieve the pain by having all of the impacted teeth extracted.

Potential Symptoms

Pain throughout the teeth, gums, and jaw is a common symptom you may notice first when one or more of your teeth become impacted. Your pain may present as a head or jaw ache at times. Over the counter pain relievers have little effect on the pain, especially as the tooth becomes lodged in place.


You may also notice that your breath odor has worsened, and it may be difficult to open your mouth all the way while eating or yawning. If you notice any redness or swelling in your gums, you may be developing an infection around the impacted tooth. An infection can cause the lymph nodes in the neck to swell as the immune system tries to deal with the invading bacteria.

Diagnostic Tests

Your dentist will perform a series of x-rays to take a look at the position of the teeth below the gum line. If any teeth look impacted, the dentist will determine the severity and then search for signs of an infection. Upon gathering all of the diagnostic information, your dentist will discuss the findings with you and assist in developing a comprehensive treatment plan.

Treatment Options

The two available treatment options involve either patiently waiting to see how the impacted tooth moves within the mouth, or surgical extraction. If you are not experiencing any pain or discomfort from the impaction, and no signs of infection currently exist, your dentist may suggest that you wait to see if the problem resolves itself naturally. For individuals dealing with ongoing noticeable symptoms, most dentists will recommend immediate removal of the offending tooth.

Observation Risks

If you decide to wait on the surgical option, the main risk involves the development of complications related to the incoming tooth. The impacted tooth may start to push the adjacent teeth out of the way, which may rotate the incoming tooth on its side or loosen your permanent teeth around the affected site.

If an infection is developing but does not show at the time of the diagnostic appointment, your impacted tooth could develop an abscess that can grow rapidly in size and severity. During the observation period, your dentist may suggest utilizing warm salt water rinses to soothe the gums and reduce the risk of infection. You can create the rinse by dissolving ½ teaspoon of salt into eight ounces of water.

If the impacted teeth begin to come in on their own and start to cause pain or other problems in the jaw, it is best to have them removed as soon as possible. Waiting too long allows the roots to curve further down into the gums and then harden – a situation that can complicate the extraction process.

Extraction Procedure


For most individuals, the dental extraction procedure is performed on an outpatient basis – as long as complications don’t develop, you will likely be released to go home soon after the procedure is completed. Therefore, you will need to bring along or call for a driver to take you home after your extraction appointment.

Unless you suffer from severe anxiety related to dental or medical procedures, your dentist will likely utilize a combination of local anesthetic and nitrous oxide to keep you from feeling pain or discomfort during the procedure. Individuals with high levels of anxiety may need to have general anesthesia during extraction, though that could require a hospital stay as well.

For a simple wisdom tooth extraction, dentists use purpose-built tools to expand the socket and pull the tooth out of the gums. When the tooth is impacted and is resting beneath the permanent teeth, the procedure often requires the use of an elevator to draw the tooth up toward the surface of the gums. Once the tooth is within range, it is pulled from the gums using specially designed forceps.


After the tooth extraction procedure, you may notice some residual pain and swelling plus bleeding at the extraction site. Your dentist will likely pack the area with gauze and have you bite down gently to help soak up the excess blood. Upon returning home, you should take any prescribed medications to help control pain and swelling as directed by your dentist.

You will only be able to eat soft foods after the procedure – like yogurt, applesauce, ice cream, and soup. You can drink non-carbonated beverages, but do not use a straw. The sucking motion required for drinking through a straw (or smoking cigarettes) can cause dry socket, which is a painful condition resulting from the loss of the blood clot in your tooth socket.

You will likely feel fully recovered within a week. At the scheduled follow-up visit with your dentist, you will learn if it is permissible to resume your regular diet and activities. If your dentist notices any signs of an infection after the extraction, you will likely need to take antibiotics to make a full recovery.

With your new found understanding of tooth impaction symptoms and the available treatment options, you can quickly respond to and resolve your dental problems as they occur. If you suspect you have an impacted tooth, or simply anticipate the upcoming arrival of your wisdom teeth, make an appointment with a board certified oral surgeon for a consultation today.

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