Impacted Teeth: Risks and Treatment Options

Q: Impacted Teeth: Risks and Treatment Options

Dear Miss Xiao Xiao： Hello! As mentioned, if correction is needed, teeth must be extracted; otherwise, observation is recommended. 2. The likelihood of impacted teeth erupting on their own is very low. 3. It is possible. 4. The chances are much higher than

Third molars (wisdom teeth)

The first mandibular premolar is a horizontally impacted tooth (the cusps are positioned directly beneath the first molar, forming a V-shape, with the crown resting against the cusp of the first premolar, and the lower edge of the crown slightly exceeding the cusp by about 0.2 mm).
The tooth shape is normal, and there is a small piece of primary tooth that has not yet fallen out.
The first molar is slightly tilted forward at a 10-degree angle.
Chewing has become habitual, the dental arch is aesthetically pleasing and well-aligned, with no missing teeth or caries.
If the primary tooth is extracted, there will be a 0.6 mm space.
Currently, there is no inflammation in the teeth, biting hard objects does not cause pain, and there are no uncomfortable symptoms.

1.
If left untreated, what are the potential risks?
2.
What is the likelihood of the impacted tooth erupting on its own if the primary tooth is extracted?
3.
If the primary tooth and the impacted tooth are extracted first, will this cause the adjacent teeth to tilt toward the gap, increasing the risk of caries?
4.
If orthodontic treatment is pursued, what is the success rate of successfully bringing this impacted tooth into alignment? Thank you.

Xiao Xiao, 10~19 year old female. Ask Date: 2018/03/08

Dr. Huang Tingfang reply Dentistry

Dear Miss Xiao Xiao: Hello! As mentioned, if correction is needed, teeth must be extracted; otherwise, observation is recommended.
2.
The likelihood of impacted teeth erupting on their own is very low.
3.
It is possible.
4.
The chances are much higher than (2)! However, if the tooth root is fused, it cannot be extracted.
Please communicate more with your doctor! Thank you! Wishing you safety! Sincerely, Dr.
Huang Ting-Fang, Dentistry.

Reply Date: 2018/03/08

More Info

Impacted teeth, particularly in the context of your lower first premolar being positioned parallel to the adjacent teeth, can present a variety of risks and treatment options. Understanding these aspects is crucial for making informed decisions regarding your dental health.

1. Risks of Leaving Impacted Teeth Untreated: If you choose to leave the impacted tooth untreated, there are several potential risks. Over time, the impacted tooth can lead to complications such as:
- Infection: The area around the impacted tooth can become infected, leading to pain, swelling, and potentially more serious systemic issues.

- Cyst Formation: Impacted teeth can sometimes lead to the development of cysts, which are fluid-filled sacs that can damage surrounding bone and teeth.

- Resorption of Adjacent Teeth: The pressure from the impacted tooth can cause resorption (deterioration) of the roots of adjacent teeth, potentially leading to their loss.

- Misalignment: As your teeth continue to shift, the presence of an impacted tooth can lead to misalignment of your bite, which may necessitate orthodontic treatment later.

2. Likelihood of Eruption After Milk Tooth Extraction: The chance of the impacted tooth erupting after the removal of the primary (milk) tooth can vary. Generally, if the primary tooth is removed and there is sufficient space (as you mentioned, 0.6mm), there is a reasonable chance that the impacted tooth may erupt. However, this is not guaranteed, especially if the tooth is significantly impacted or if there are other anatomical factors at play.

3. Consequences of Extracting Both Teeth: If you decide to extract both the primary tooth and the impacted tooth, there is a risk that the adjacent teeth may tilt toward the space left by the missing teeth. This tilting can lead to:
- Crowding: The adjacent teeth may shift into the space, causing crowding and misalignment.

- Increased Risk of Cavities: Misaligned teeth can be harder to clean, increasing the risk of cavities and gum disease.

4. Orthodontic Treatment for Impacted Teeth: If you opt for orthodontic treatment to address the impacted tooth, the success rate for bringing an impacted tooth into alignment can be quite high, especially if the tooth is not severely impacted. Factors that influence the success of orthodontic treatment include:
- Age: Younger patients tend to have more successful outcomes because their bones are still developing and more malleable.

- Position of the Tooth: The degree of impaction and the position of the tooth relative to the surrounding teeth play a significant role.

- Orthodontic Technique: The experience and technique of the orthodontist can also affect the success rate.

In conclusion, while your impacted tooth may not currently be causing any discomfort or issues, it is essential to consider the long-term implications of leaving it untreated. Consulting with an oral surgeon or orthodontist can provide you with tailored advice based on your specific dental situation. They can help you weigh the risks and benefits of various treatment options, including extraction, orthodontic intervention, or monitoring the situation over time. Regular dental check-ups will also be crucial in managing your dental health as you make these decisions.

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