Impacted Tooth: Causes, Complications, and Treatment

Impacted teeth don’t always announce themselves with pain, but they can quietly create problems below the surface. Whether it’s a wisdom tooth that never came in or a canine stuck in the gums, knowing what to watch for (and when to act) helps you stay ahead of dental trouble.

Let’s discuss what an impacted tooth is, which ones are most likely to be affected, and how to recognize when it’s time to take the next step.

What is an Impacted Tooth?

An impacted tooth is one that cannot fully erupt into its normal place in the mouth. This may happen because there isn’t enough room in the dental arch, or the tooth is blocked by bone, gums, or other teeth.

There are three types of impaction:

• Soft-tissue impaction means the tooth has broken through the jawbone but is still trapped beneath the gums.
• Partial bony impaction means part of the crown is stuck in the bone.
• Full bony impaction means the entire tooth remains encased in the jawbone.

These categories help dentists decide on the best treatment plan. If you think a tooth is “stuck,” it’s best to consult your dentist and book an exam.

What Types of Teeth are Commonly Impacted?

Wisdom teeth (also called third molars) are the most commonly impacted. These usually try to come in between the ages of 17 and 25, but often don’t have the space they need. As a result, they may come in at an angle or stay fully beneath the gums.

Maxillary canines—your upper "eye teeth"—are next in line. They guide your bite and are important for chewing, which is why dentists try to help them erupt rather than remove them.

Most cases of canine impaction affect only one side and are more common in girls than in boys. Ask your dentist which tooth is involved and how its position affects choices.

What are the Symptoms of an Impacted Tooth?

Many impacted teeth cause no discomfort at first. But over time, they can lead to symptoms that signal active disease or irritation.

Watch for these signs that something may be wrong:

• Ongoing bad breath or a bad taste near the back of your mouth
  
• Pain or pressure in the gums or jaw that comes and goes
  
• Swollen or red gums, especially around a partially visible tooth
  
• Trouble opening your mouth fully, also called trismus
  
• A missing “canine bulge” in children where the upper eye tooth should develop

Sudden fever, swelling that spreads, or trouble opening your mouth fully needs urgent care. Call if red flags appear or symptoms persist beyond 48–72 hours.

Diagnosis and Imaging

To diagnose an impacted tooth, your dentist will first perform a visual exam and check your dental history. But the real insight comes from imaging.

A panoramic X-ray is the standard tool. It shows the full jaw, the direction of tooth growth, and whether the roots are close to nerves or sinuses.

If this X-ray raises concerns—like nerve overlap, root resorption, or an abnormal lesion—a 3D dental scan (CBCT) may follow. CBCT detects problems like root damage more often than a standard pano.

What Causes Impacted Teeth?

Most cases of impacted teeth are due to overcrowding. There just isn’t enough room in the jaw for all the teeth to line up properly. This lack of space is especially common for wisdom teeth.

Other causes can block the path of eruption, and they include:

• Supernumerary teeth (extra teeth)
• Over-retained baby teeth
• Small tumors (odontomas)
• Past dental trauma

Genetics may also play a role, especially in complex cases or certain inherited conditions. If your child has retained baby teeth or a history of dental trauma, ask about early imaging.

Complications That Can Occur from Impacted Teeth

Impacted teeth aren’t always harmless. Over time, they can lead to infections, damage nearby teeth, or even form cysts.

Here are the main complications to watch for:

• Pericoronitis, a painful gum infection over a partially erupted tooth
  
• Tooth decay in areas that are hard to clean
  
• Gum disease that can affect adjacent molars, especially second molars
  
• Cysts or tumors developing in the tissue around the trapped tooth
  
• Root resorption where pressure erodes the nearby tooth’s root

Worsening pain or swelling with fever needs prompt evaluation. Review your own X-ray with the clinician to spot these risks early.

Treatment Options for Impacted Teeth

Not all impacted teeth need surgery. Depending on the tooth’s location, your age, and whether problems are already developing, your provider may recommend monitoring, removing the tooth, or helping the tooth erupt with braces.

Experts disagree on removing “quiet” third molars. One group recommends early removal to avoid future risks, while another advises waiting unless a disease is found. 

When a tooth is truly disease-free, active surveillance with routine checkups may be appropriate. However, delaying needed surgery increases the risk of complications with age.

Ask whether your case is better served by removal, exposure, or a watch plan.

Tooth Extraction

Wisdom teeth are the most common teeth removed. If they’re stuck, angled toward the next tooth, or causing infections, extraction is often the safest route.

For other teeth, like canines or incisors, exposure and orthodontics are usually preferred over removal.

Third molar removal becomes more complex with age. Risks include:

• Dry socket ⁠— This can affect up to 30% of high-risk surgical cases, but most people have a much lower risk.
• Injuries to the inferior alveolar nerve ⁠— This is a rare risk, but it can cause numbness in the lip or chin.

Some high-risk cases may benefit from a coronectomy, where only the crown is removed to avoid nerve damage. Numbness that doesn’t improve or worsens needs prompt follow-up.

Open Exposure

This surgical technique exposes the crown of the impacted tooth by removing the gum (and sometimes bone) covering it. The tooth is then left visible in the mouth to erupt naturally or with orthodontic help.

Some data show that open exposure can shorten alignment time, but it may also increase the chance of gum recession or discomfort during healing.

Closed Exposure

In closed exposure, the tooth is uncovered surgically, but instead of leaving it visible, a bracket and gold chain are attached to the crown. Gold chains are a common, biocompatible option.

This is the general process of the procedure:

• Once the bracket and chain are attached, the gum flap is sutured back into place.
• The chain exits through a small opening to be used for orthodontic traction.
• Once the surgical part is done, an orthodontist applies gentle force through the chain to guide the tooth into its place over several months.

This is a slow, controlled process and often takes 1 to 3 years.

Success rates are high when traction begins early and is coordinated across the care team. Recent reviews also suggest this method may result in better long-term gum health and aesthetics, though the healing period is longer.

One risk is bond failure—if the attachment comes loose under the gum, a second surgery may be needed.

Should You Choose Monitoring or Tooth Removal?

If your impacted tooth isn’t causing trouble and is truly disease-free, some dentists may recommend a strategy called active surveillance—not “wait and see,” but scheduled monitoring with X-rays.

Who qualifies? Young patients with no pain, infection, or damage to nearby teeth may be candidates. Checkups are typically every 2 years, but this only works if imaging and probing show no early disease.

Tips for Recovery and Self-Care After Treatment

The first 72 hours after surgery are key for pain control, clot stability, and preventing infection. Good self-care makes a big difference.

Follow your provider’s instructions, especially these basics:

• Use ice packs on the cheek during the first 24 hours to reduce swelling
  
• Eat soft, cool foods like yogurt, mashed potatoes, or soup for a few days
  
• Rinse with salt water starting on day 2; avoid forceful swishing or spitting
  
• Use chlorhexidine oral rinse as directed, usually starting 48 hours after surgery
  
• Avoid smoking, straws, and heavy activity during the first week of healing

If you’re experiencing worsening pain 3 or more days after your procedure, foul odor/taste, or fever, it can signal dry socket or infection. See your dentist immediately to address the issue.

Cost and Coverage of Impacted Tooth Treatment

The total cost of treatment depends on three parts: the procedure, the anesthesia, and the facility. Insurance rules can vary widely, especially between dental and medical coverage.

Here’s what to expect:

• Surgical fees range from $300–$800+ per tooth, depending on impaction type
  
• Anesthesia fees for IV sedation often range from $500–$1,000 per hour
  
• Expose and bond (for canines) averages around $1,200 per tooth
  
• Insurance coverage may exclude anesthesia or require pre-approval
  
• Payment plans are available at many offices

If you suspect an impacted tooth or were told one is present, the next step is to consult a general dentist or an oral and maxillofacial surgeon.

Bring any recent dental X-rays or ask your provider to request them. Be ready to discuss symptoms, goals, and your preferences around surgery and recovery.