Impacted teeth occur when a tooth cannot erupt into its proper position, and early orthodontic evaluation can help identify these concerns before they lead to more complex dental problems.
Most parents expect their child’s permanent teeth to come in one by one with only a few loose baby teeth and a visit from the Tooth Fairy along the way. While that is often the case, some teeth never fully emerge because they become trapped beneath the gums. These are known as impacted teeth.
An impacted tooth is not always painful or obvious, which is why many parents are surprised when an orthodontist identifies one during a routine evaluation. Understanding why impacted teeth occur and how they are treated can help parents make informed decisions about their child’s oral health.
What Is an Impacted Tooth?
An impacted tooth is a permanent tooth that cannot erupt into its normal position because something is blocking its path or there is not enough room in the jaw. Instead of emerging through the gums, the tooth remains partially or completely trapped beneath the gum tissue or bone.
While impacted wisdom teeth are common in adults, children and teenagers can also develop impacted permanent teeth. The teeth most often affected include:
- Upper canine teeth
- Premolars
- Second molars
- Occasionally, permanent front teeth
Because these teeth play an important role in your child’s bite and smile, early diagnosis is important.
Why Do Teeth Become Impacted?
There is rarely a single cause of an impacted tooth. In many cases, several factors contribute to the problem.
Crowding
One of the most common causes is simply a lack of space. If the jaw is too small to accommodate all of the permanent teeth, a developing tooth may not have enough room to erupt.
Baby Teeth That Do Not Fall Out
Sometimes a baby tooth remains in place longer than expected and blocks the permanent tooth beneath it. This can delay eruption or force the permanent tooth to develop in the wrong direction.
Abnormal Tooth Position
Occasionally, a tooth develops at an unusual angle. Instead of moving toward the gum line, it may drift sideways or become trapped against a neighboring tooth.
Genetics
Some children inherit smaller jaws, larger teeth, or eruption patterns that increase the likelihood of impacted teeth. Family history can sometimes provide important clues during an orthodontic evaluation.
Other Factors
Less commonly, impacted teeth may be associated with cysts, extra teeth, or developmental conditions that interfere with normal eruption.
The American Academy of Pediatric Dentistry offers additional information about children’s dental development and the importance of regular dental visits.
Which Teeth Are Most Commonly Impacted?
After wisdom teeth, the upper canine teeth are among the most frequently impacted teeth. These teeth are important because they help guide the bite, support the lips, and contribute to a balanced smile.
Canines also have one of the longest eruption paths of any permanent tooth. Because they develop high in the jaw, there are more opportunities for something to interfere with their normal eruption.
What Are the Signs of an Impacted Tooth?
Impacted teeth often develop without causing discomfort, making regular dental and orthodontic evaluations especially valuable.
Parents may notice:
- A permanent tooth that has not erupted long after the matching tooth on the opposite side
- A baby tooth that remains in place longer than expected
- Gaps where a permanent tooth should be
- Crowding or shifting teeth
- Swelling or tenderness in some cases
Many impacted teeth are first discovered on routine dental X-rays before any symptoms develop.
How Are Impacted Teeth Diagnosed?
Your child’s dentist or orthodontist will begin with a clinical examination to evaluate tooth eruption and bite development. If an impacted tooth is suspected, digital X-rays or three-dimensional imaging may be recommended to determine the exact position of the tooth.
These images allow the orthodontist to evaluate whether the tooth is likely to erupt on its own or whether treatment may be necessary.
The American Association of Orthodontists recommends that children receive an orthodontic evaluation by age 7, allowing many eruption concerns to be identified while the jaws are still developing.
How Are Impacted Teeth Treated?
Treatment depends on the child’s age, the position of the tooth, and the cause of the impaction.
In some cases, simply removing a stubborn baby tooth creates enough space for the permanent tooth to erupt naturally. Other children may benefit from creating additional space through orthodontic treatment.
If a tooth remains trapped beneath the gums, a collaborative approach between an orthodontist and an oral surgeon may be recommended. A small surgical procedure can expose the tooth, allowing an orthodontic attachment to gently guide it into its proper position over time.
Every treatment plan is customized to the child’s individual needs.
Why Early Orthodontic Evaluations Matter
Many impacted teeth can be detected years before they would normally erupt. Early orthodontic evaluations allow specialists to monitor tooth development and identify potential concerns before they become more difficult to treat.
In some situations, early intervention may reduce the complexity of future treatment or improve the chances that a permanent tooth will erupt successfully. Even if no treatment is recommended right away, regular monitoring allows your orthodontist to determine the best timing if intervention becomes necessary.
What Happens If an Impacted Tooth Is Left Untreated?
An untreated impacted tooth can sometimes lead to complications, depending on its location and severity.
Potential concerns include:
- Damage to neighboring teeth
- Crowding or shifting teeth
- Delayed eruption of other permanent teeth
- Bite problems
- Formation of cysts in rare cases
- Difficulty cleaning surrounding teeth
Not every impacted tooth requires immediate treatment, but early diagnosis gives families more options and helps prevent small concerns from becoming larger ones.
Key Takeaways
- An impacted tooth is a permanent tooth that cannot erupt normally because it is blocked or lacks adequate space.
- Upper canine teeth are among the most commonly impacted permanent teeth in children.
- Crowding, retained baby teeth, abnormal tooth position, and genetics are common causes.
- Many impacted teeth cause no symptoms and are discovered during routine dental or orthodontic imaging.
- Early orthodontic evaluations can identify eruption problems before they become more complex.
- Treatment may involve monitoring, creating space, removing a baby tooth, or guiding the impacted tooth into place with orthodontic care.
Frequently Asked Questions
What is an impacted tooth?
An impacted tooth is a tooth that cannot fully erupt into its normal position because it is blocked by bone, gum tissue, another tooth, or inadequate space in the jaw.
Are impacted teeth painful?
Not always. Many impacted teeth cause no discomfort and are discovered during routine dental X-rays or orthodontic evaluations.
Which teeth are most likely to become impacted?
After wisdom teeth, the upper canine teeth are among the most commonly impacted permanent teeth.
Can an impacted tooth erupt on its own?
Sometimes. If the obstruction is removed early enough, a tooth may erupt naturally. In other cases, orthodontic treatment or minor oral surgery may be needed.
How can an orthodontist tell if a tooth is impacted?
Orthodontists use clinical examinations along with digital X-rays or three-dimensional imaging to evaluate the position and development of permanent teeth.
When should my child have their first orthodontic evaluation?
The American Association of Orthodontists recommends that children have their first orthodontic evaluation by age 7. Early screenings allow orthodontists to monitor eruption patterns and identify concerns before they become more difficult to treat.
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This is intended to be general guidance but if you’re unsure about whether your child may need an orthodontic evaluation, please confer with Dr. Erica, Tampa Bay’s only dual certified pediatric dentist and pediatric orthodontist. Call today for an appointment at our Odessa / Citrus Park office. We look forward to meeting you and your child!
