Impacted Tooth in Children Warning Signs and Tips for Dealing with the Problem

Have you noticed that your child hasn’t developed a certain tooth, like a canine, at the expected time? Is there a gap between the teeth or swelling in the gums? These signs may indicate an impacted tooth under the gum in children—a common issue that requires careful monitoring to prevent problems with tooth alignment, chewing, or speech. In this Dalily Medical article, we will explore the causes of impacted teeth, their symptoms, diagnostic methods, and the different stages of treatment, along with practical tips for managing the issue before it becomes more complicated.

Impacted Teeth in Children: Causes, Symptoms, and Treatment

Causes of Impacted Teeth
An impacted tooth is one that remains under the gum and does not erupt at the expected time. The main causes include:

Limited jaw space: If the jaw is small, the tooth may not have enough room to emerge.
Primary tooth still present: If the baby tooth hasn’t fallen out, it can block the permanent tooth from coming in.
Gum or bone obstruction: Thick gums or a bony barrier can prevent the tooth from erupting.
Genetics: Sometimes impacted teeth run in the family.
Trauma or injury: Any blow to the jaw or teeth may affect tooth eruption.
Infections or cysts: Inflammation or a cyst around the tooth can prevent its appearance.

Symptoms of Impacted Teeth
Impacted teeth are not always visible, but some signs may be noticeable:

Delayed eruption: Permanent tooth hasn’t appeared on time, or the baby tooth fell out without a replacement.
Gaps or misalignment: Adjacent teeth may shift or crowd.
Mild pain or pressure: The child may feel slight discomfort as the tooth tries to erupt.
Swelling in the gums: A small bump or raised gum margin may appear.
Chewing difficulties: Occasionally, the impacted tooth affects eating.
Infections or cysts: Redness or sensitivity may occur if a cyst or inflammation surrounds the tooth.

Types of Impacted Teeth in Children
Impacted teeth can be classified based on the type of tooth, location, and eruption direction:

By tooth type
- Anterior teeth (canines or upper incisors): Most commonly impacted in children, usually due to delayed baby tooth loss or limited jaw space.
- Permanent molars: Less common, often caused by limited space or a bony obstruction.
By location
- Fully impacted in the bone: Tooth remains under the bone and hasn’t reached the gum; may require minor surgery.
- Partially impacted under the gum: A small part of the crown is visible, but the tooth hasn’t fully erupted; may be painful and requires monitoring.
By eruption direction
- Straight canine: Tooth in normal position but hasn’t emerged.
- Angled or rotated canine: Tooth leans toward adjacent teeth or backward, causing crowding or alignment issues.
- Horizontal or inverted canine: Very rare, may result from trauma or jaw development problems.

Stages of Impacted Teeth in Children

Development within the bone:
The tooth forms inside the bone under the gum, developing the crown and root. Usually, the child shows no symptoms.
Movement toward the gum:
The tooth starts moving toward the gum surface. Mild pressure, swelling, or discomfort may occur.
Impaction or obstruction:
Movement stops due to limited jaw space or a gum/bone barrier. The tooth may be partially or fully submerged, causing swelling, pain, or misalignment of nearby teeth.
Diagnosis and treatment planning:
The tooth is detected via clinical examination or imaging (e.g., panoramic X-ray). The dentist decides whether to monitor or perform minor surgery to expose or guide the tooth.
Final eruption or stabilization:
After treatment, the tooth erupts naturally or is guided with orthodontics. The goal is proper alignment and preventing chewing or crowding problems.

Risks of Impacted Teeth
Impacted teeth can cause several complications if left untreated:

Misalignment of teeth: Adjacent teeth may shift or crowd.
Chewing and speech difficulties: Especially if an anterior tooth is impacted.
Cysts or infections: Can lead to swelling and discomfort.
Damage to adjacent roots: Tilted teeth can press on neighboring roots.
Cosmetic concerns: Large gaps or misaligned teeth affect the child’s smile.
Complicated treatment: Delayed detection may require more extensive surgery or longer orthodontic treatment.

Diagnosis of Impacted Teeth

Clinical examination: Dentist checks for unusual gaps, slight swelling, and delayed eruption. Child may report mild pain or pressure.
X-rays:
- Panoramic X-ray: Shows the entire jaw and tooth relationships.
- Periapical X-ray: Focuses on specific areas for detailed views of roots and teeth.
- 3D CBCT scan: Used in complex cases to pinpoint the exact position and surrounding bone.
Treatment assessment: Dentist decides between monitoring, surgical exposure, or orthodontic guidance depending on tooth position and impact on neighboring teeth.

Surgical Treatment for Impacted Teeth

Fully impacted tooth:
- Surgical exposure may be required.
- Orthodontic guidance may be used if the tooth is important.
- Severely misaligned teeth that threaten adjacent teeth may be removed.
Partially impacted tooth:
- Excess gum or barriers are removed.
- Tooth may erupt naturally with monitoring.
- Orthodontics may guide the tooth if necessary.
Malpositioned tooth:
- Surgically exposed and guided with braces if possible.
- Severely misaligned teeth affecting adjacent teeth may be extracted.
Supernumerary tooth (extra tooth):
- Removed surgically to prevent crowding or jaw problems.
- Post-removal orthodontics may be required to align natural teeth.

Post-Surgery Tips

Regular follow-up with a pediatric dentist to ensure proper alignment.
Maintain oral hygiene to promote gum healing.
Use orthodontic appliances if needed to guide the tooth.

General Tips for Managing Impacted Teeth in Children

Regular dental check-ups: Every 6 months to monitor tooth and jaw development.
Proper oral hygiene: Brush regularly with a soft-bristled brush and fluoride toothpaste, even if the tooth is impacted.
Monitor baby and permanent teeth eruption: Early consultation if delays occur.
Watch for pain or swelling: Persistent discomfort, redness, or discharge needs prompt evaluation.
Surgical intervention when necessary: Early treatment is simpler and less invasive.
Manage extra teeth: Supernumerary teeth usually require removal to prevent crowding.
Patience and monitoring: Some impacted teeth gradually emerge, requiring ongoing observation.

This comprehensive approach helps ensure that impacted teeth in children are managed safely, minimizing complications and promoting proper dental development.

Best doctors أطفال

featured