An impacted tooth is one that does not fully emerge through the gum line into its proper position. This occurs when there is not enough space in the jaw, or the tooth is growing at an incorrect angle. While some impacted teeth may not cause immediate problems, others can lead to various oral health issues. This article explores the potential consequences if an impacted tooth is not removed.
Common Local Issues
An unremoved impacted tooth can frequently lead to localized discomfort. Pain is a common symptom, often manifesting as a persistent ache or throbbing sensation in the jaw or surrounding gum tissue. Swelling can also occur around the area where the tooth is attempting to erupt, making the jaw feel tender and sometimes limiting the ability to open the mouth fully.
Infection, particularly pericoronitis, is a frequent complication. This develops when the gum tissue partially covering an impacted tooth becomes inflamed and infected. Food particles, plaque, and bacteria can easily become trapped underneath this flap of gum, creating a breeding ground. This can result in redness, swelling, and pus discharge from the affected gum, often accompanied by a foul taste or bad breath.
Maintaining proper oral hygiene is challenging around an impacted tooth, especially if partially erupted. The inability to thoroughly clean the area allows plaque and bacteria to accumulate. This poor hygiene contributes to the risk of both pericoronitis and tooth decay on the impacted tooth itself.
Harm to Nearby Teeth and Bone
Beyond localized discomfort, an impacted tooth can damage neighboring teeth and bone structures. A significant concern is the increased risk of decay on the adjacent tooth. When an impacted tooth is positioned close to a neighboring molar, food and bacteria can become trapped in the tight space, making effective cleaning difficult. This persistent accumulation of debris can lead to cavities forming on the surface of the adjacent tooth, often in an area difficult to access.
The pressure exerted by an impacted tooth can also cause root resorption on the adjacent tooth. This condition involves the gradual wearing away of the root surface of the neighboring tooth. The chronic pressure from the impacted tooth can stimulate cells that resorb the root structure, potentially weakening the affected tooth over time.
Additionally, an impacted tooth can contribute to bone loss in the surrounding area. The chronic inflammation and infection associated with an impacted tooth, such as pericoronitis, can lead to the destruction of the alveolar bone that supports the teeth. This bone loss can affect not only the bone around the impacted tooth but also the bone supporting the adjacent teeth, compromising their stability and health.
Potential for Serious Pathological Outcomes
While less common, an unremoved impacted tooth can lead to more serious pathological developments. One such outcome is the formation of a dentigerous cyst. This is a fluid-filled sac that can develop around the crown of an unerupted or impacted tooth. As the cyst slowly expands, it can exert pressure on surrounding bone, causing it to resorb and potentially damaging adjacent teeth and even nerves.
In extremely rare instances, the lining of a dentigerous cyst can undergo changes that lead to a benign tumor, such as an ameloblastoma. While not cancerous in the malignant sense, these tumors can be locally aggressive and cause significant destruction of jaw bone if not treated. Their occurrence is infrequent but represents a serious potential long-term complication.
Furthermore, an impacted tooth, particularly a wisdom tooth, can contribute to broader orthodontic issues. The pressure from an impacted tooth attempting to erupt can sometimes lead to crowding or misalignment of other teeth in the dental arch. This can negate previous orthodontic treatment or create new aesthetic and functional problems, potentially requiring further orthodontic intervention.
Circumstances for Observation
Not every impacted tooth requires immediate removal; some can be monitored under specific conditions. A dentist might recommend observation if the impacted tooth is completely asymptomatic, meaning it causes no pain, swelling, or other issues. This approach is considered when the tooth is fully encased within the jawbone and shows no signs of associated pathology.
Observation also applies if there is no evidence of a cyst, tumor, or damage to adjacent teeth or bone. Regular dental check-ups are essential, with periodic X-rays to monitor the tooth’s position and surrounding structures. This allows detection of changes or developing problems early, ensuring timely intervention if the tooth causes complications.