An impacted tooth is a tooth that remains inside the jawbone or gum even though its normal eruption time has come and cannot take its place in the mouth. It is most common in wisdom teeth, followed by upper canines. Impacted teeth are often noticed by chance during a routine X-ray and may show no symptoms. In this case, patients’ most frequent question is whether extracting the tooth is really necessary. Knowing the answer to the question of what happens if an impacted tooth is not extracted helps you make the extraction or monitoring decision consciously. As DijiDent Oral and Dental Health Polyclinic, we evaluate the impacted teeth of our patients in Türkiye with three-dimensional imaging.
Why Do Teeth Remain Impacted?
- Lack of space: The jaw not being large enough for all the teeth to erupt is the most common cause.
- Abnormal position or angle: The tooth developing horizontally or in the opposite direction.
- Obstructing structures: Retained baby teeth, extra teeth or cysts.
- Thick bone or gum: The eruption path of the tooth being blocked.
- Genetic factors: Familial predisposition may play a role.
What Can Happen If an Impacted Tooth Is Not Extracted?
A significant portion of impacted teeth can remain for years without causing any problems. However, in some situations various problems may develop over time:
Pericoronitis (Gum Inflammation)
Food debris and bacteria accumulating under the gum covering partially erupted teeth can lead to recurrent inflammation, pain, swelling and limited mouth opening.
Caries and Root Resorption in the Neighboring Tooth
An area that cannot be cleaned may form between an angled impacted wisdom tooth and the second molar. Caries developing in this area can threaten the healthy neighboring tooth. The pressure of the impacted tooth can also cause resorption in the root of the neighboring tooth.
Cyst and Tumor Formation
The tissue sac surrounding the crown of the impacted tooth can enlarge over time and form a cyst. Cysts often grow painlessly and can lead to loss of the surrounding bone and displacement of neighboring teeth. In rare cases, tumor-like lesions may also be seen.
Gum Disease
Deep pockets and bone loss can develop around the wisdom tooth, and this can also affect the support of the neighboring tooth.
Denture Problems
In edentulous jaws, as the bone resorbs, an impacted tooth that was previously inside the bone may come closer to the surface and cause problems with denture pressure.
Risk of Jaw Fracture
Large impacted teeth in the lower jaw can weaken the bone and increase the risk of fracture in the event of trauma.
Impacted Canines
Upper canines are very important aesthetically and functionally. For impacted canines, instead of extraction, the aim is generally to bring the tooth into its place in the mouth with orthodontic treatment. In this procedure, the tooth is surgically exposed, a small attachment is bonded to it and the tooth is slowly moved into place with orthodontic forces. Early diagnosis increases the success of this treatment; for this reason, regular check-ups during childhood are important.
Extract or Monitor?
The decision is individual and is made according to the following factors:
- Symptoms: The presence of pain, swelling or recurrent inflammation.
- Radiographic findings: A cyst, damage to the neighboring tooth or bone loss.
- Position of the tooth: Is it fully inside the bone, or is it connected to the mouth?
- Patient’s age: In young patients, the roots may not yet be fully developed and healing is generally faster.
- Surgical risks: Proximity to structures such as the nerve and sinus.
- General health: The presence of systemic diseases at an older age.
Impacted teeth that are fully inside the bone, asymptomatic and show no pathology can be monitored with regular radiographic follow-up, especially in situations where the surgical risk is high. When a monitoring decision is made, it is important not to miss the check-ups.
When a Monitoring Decision Is Made
If it has been decided to monitor the impacted tooth instead of extracting it, clinical examination and radiographic checks are carried out at certain intervals. At these check-ups, whether there is cyst formation around the tooth, change in the neighboring tooth or bone loss is evaluated. During this process, if you notice pain, swelling, a bad taste or a change in sensation in the jaw area, it is recommended that you contact your clinic without waiting for the check-up date.
Age and Timing
If extraction is necessary, healing is generally faster and the risk of complications may be lower in procedures done at a young age. In later years, the bone becomes denser and healing may take longer. For this reason, appropriate timing is important for teeth with a high potential to cause problems.
The Importance of Three-Dimensional Evaluation
The position of impacted teeth, their root structure and their relationship with neighboring structures can be evaluated in detail with three-dimensional dental tomography. At DijiDent, by examining this evaluation on screen together with our patients, we clearly share the reasons for the extraction or monitoring decision.
Frequently Asked Questions
Not always. Teeth that are asymptomatic and show no pathology can be monitored in some situations; the decision is made through examination.
In some situations, a cyst may develop around an impacted tooth. Regular follow-up is important in this respect.
Generally, instead of extraction, the aim is to bring it into place with orthodontic treatment.
Yes; however, healing may take longer and the general health condition is carefully evaluated.
In some situations, it can lead to caries or root resorption in the neighboring tooth.
Let us make the right decision for your impacted tooth together.
Contact us to book an appointment to learn whether your impacted tooth should be extracted or monitored. Let us carry out your three-dimensional evaluation at DijiDent Oral and Dental Health Polyclinic.
This content is for general information purposes and does not replace an examination by a dentist. The extraction or monitoring decision is made after clinical and radiographic evaluation.
