Summary about Disease
Tooth impaction occurs when a tooth fails to erupt fully through the gum line and into its proper position within the dental arch. This is most common with wisdom teeth (third molars), but can affect other teeth as well. Impaction can be partial, where some of the tooth is visible, or complete, where the tooth remains entirely beneath the gum and/or bone. Impaction can cause pain, infection, damage to adjacent teeth, and other complications.
Symptoms
Symptoms of tooth impaction can vary depending on the degree of impaction and the presence of complications. Common symptoms include:
Pain or tenderness in the jaw near the impacted tooth.
Swelling or redness of the gums around the affected area.
Headache or jaw ache.
Difficulty opening the mouth fully.
Bad breath or a bad taste in the mouth.
Pain when chewing or biting.
Damage to adjacent teeth, shifting of teeth, or overcrowding.
Infection of the surrounding tissues (pericoronitis).
In some cases, there may be no noticeable symptoms.
Causes
The most common causes of tooth impaction include:
Lack of space in the jaw to accommodate the tooth.
The tooth being blocked by other teeth, bone, or soft tissue.
Abnormal tooth size or shape.
Abnormal eruption path.
Genetic factors.
Medicine Used
Medications used in connection with tooth impaction primarily address pain, swelling, and infection:
Pain relievers: Over-the-counter pain relievers like ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) can help manage mild to moderate pain. Prescription pain medications may be needed for more severe pain.
Antibiotics: If an infection is present, antibiotics such as penicillin, amoxicillin, or clindamycin may be prescribed to fight the infection.
Antiseptic mouthwash: Chlorhexidine mouthwash may be recommended to keep the area clean and reduce the risk of infection.
Is Communicable
Tooth impaction itself is not communicable. It is a developmental issue related to the tooth's eruption process and jaw structure. However, any infection that may arise as a consequence of impaction (e.g., pericoronitis) is also not directly communicable as it's typically due to the individual's own oral bacteria.
Precautions
Precautions to prevent complications from tooth impaction include:
Regular dental check-ups to monitor tooth development and identify potential impactions early.
Following your dentist's recommendations regarding extraction or other treatments.
Maintaining good oral hygiene, including brushing and flossing, to prevent infection.
Using antiseptic mouthwash as directed by your dentist.
Avoiding hard or chewy foods that may irritate the area around the impacted tooth.
If extraction is recommended, carefully following post-operative instructions to promote healing and prevent complications.
How long does an outbreak last?
Tooth impaction isn't an "outbreak" in the infectious disease sense. The duration of symptoms related to impaction depends on whether there are associated complications, such as pericoronitis or nerve damage. Pain, swelling, and inflammation can persist for days to weeks if left untreated. If an infection (pericoronitis) develops, it can last until treated with antibiotics and proper oral hygiene. However, chronic discomfort can persist until the impacted tooth is addressed by way of extraction.
How is it diagnosed?
Tooth impaction is diagnosed through a combination of:
Clinical Examination: A dentist will examine the mouth for signs of swelling, redness, and tenderness around the area where a tooth is expected to erupt.
Dental X-rays: X-rays, such as panoramic radiographs (Panorex) or cone-beam computed tomography (CBCT), are essential for visualizing the position, angulation, and depth of the impacted tooth, as well as its relationship to adjacent structures like nerves and sinuses.
Timeline of Symptoms
The timeline of symptoms can vary:
Early stages: Mild discomfort or pressure in the jaw. Sometimes, no symptoms.
As the tooth attempts to erupt: Increased pain, swelling, and redness. Possible headache or jaw ache. This can come and go.
With infection (pericoronitis): Intense pain, swelling, difficulty opening the mouth, bad breath. This can develop rapidly.
If untreated: Chronic pain, damage to adjacent teeth, cyst formation.
Important Considerations
Early detection is key: Regular dental check-ups are crucial for identifying potential impactions before they cause significant problems.
Treatment options vary: Depending on the severity of the impaction and the presence of symptoms, treatment options may include monitoring, pain management, antibiotics (if infection is present), or extraction.
Nerve damage: Extraction of impacted lower wisdom teeth carries a risk of nerve damage, which can cause numbness or tingling in the lip, chin, or tongue. Your dentist will assess this risk before recommending extraction.
Second opinion: If you are unsure about the recommended treatment plan, consider seeking a second opinion from another dentist or oral surgeon.
Individualized approach: The best course of treatment for tooth impaction depends on individual factors, such as age, overall health, and the specific characteristics of the impaction.