Teeth included, retained or impacted and their treatment

Teeth included, retained or impacted and their treatment

Symptoms & Treatments

The teeth included, also known as retained or impacted, are those teeth that, despite having been fully formed, have not come to emerge in the mouth during the usual period, and remain within the maxilla partially or completely.

Although it can occur, indistinctly, with temporary teeth (children’s milk teeth) or permanent teeth, as well as in any dental piece, the inclusion process is more common in the wisdom teeth – teeth and in the canines -colors- superiors. It is so given that these are the last teeth to erupt in the mouth and, therefore, tend not to have enough space to exit.

It is a very frequent situation among the population over 15 years old and its serious consequences require an early reaction. For the detection of these included teeth, a panoramic radiograph of the mouth will be performed to help rule out pathologies and determine the causes of delayed eruption.

If you are feeling pain or other unpleasant side effect due to impacted or included teeth, you should consult with Dubai dentist. Dentist may suggest an extraction surgery, and if its create negative side effect then may recommend extraction. 

Classification of teeth included

There are two types of tooth inclusions:

  • Total inclusion: This is the case of those teeth that have remained completely inside the maxillary bone and that have not emerged in the least through the gum.
  • Partial inclusion: Semi-included or semi-impacted teeth are those that have partially erupted in the mouth and, given their position, are more vulnerable to bacteria in the mouth so they can suffer recurrent infections.

In cases where the tooth emerges partially, you can see some symptoms such as inflammation and sensitivity in the gums, so they are easier to detect than fully enclosed teeth.

These are some of its symptoms :

  • Bad breath
  • Pain or tenderness in the gums
  • Prolonged jaw or headache
  • Redness of the gums that are located around the tooth retained
  • Unpleasant mouthfeel
  • Visible space where the tooth should have come out

Causes and complications derived from retained teeth

Although not in all cases there is a clear factor that has led to a tooth included, some of the most common causes of this process are the following:

  • Infections
  • Trauma
  • Genetics
  • Lack of mouth space
  • Malnutrition

As far as the consequences derived from the dental inclusions can be numerous and some very serious, since the included tooth that acquires a malposition can impact against the neighboring teeth and cause some of the following complications:

  • Resorption of the root
  • Damage to the anatomical structure (maxillary sinus, nerve trunks, roots of adjacent teeth …)
  • Infections
  • Alterations in the rest of teeth (can cause crowding )
  • Appearance of periodontal pockets
  • Chewing problems
  • Formation of caries by the plaque accumulated between the teeth and gums
  • Development of cysts or tumors
  • Chronic discomfort in the mouth
  • Malocclusion

You will be interested: Oral health from the age of 60

What is the treatment for the included teeth?

When we find the situation of a tooth retained in the maxillary bone, we can apply three types of treatments:

  1. Do not act on the impacted tooth and control its evolution: We will only act in this way when there is no risk of any pathology occurring. In practically all cases, the other two treatments are used.
  2. Extraction of the retained tooth: Although it would be the last resort in the case of an included canine – unless there is a serious problem – it is quite common to perform an extraction in the case of wisdom teeth.
  3. Repositioning of the tooth included in the dental arch: When the tooth in question has a functional and / or aesthetic importance -as it is the case of the canines- we will choose to try to relocate it in the place where it should have erupted.

Teeth extraction surgery included (wisdom teeth)

Problems of eruption of wisdom teeth are very common because in the evolution of man, the jaw has been decreasing in size more quickly than the number of teeth that the human being possesses. That is why, on many occasions, these wisdom teeth do not find enough space to emerge and end up retained in the maxilla. And given its limited practical functionality and its lack of aesthetic functionality, the most advisable, in most cases, is to extract them to avoid, thus, possible complications (infections, movement of the rest of teeth …).

This type of surgery is very frequent and should be done before the patient develops the root of the tail (before 20 years of age), since the greater the root, the greater the contact with the nerve and the greater the risk during exodontia.

It is a surgical intervention of less than half an hour and which, in the great majority of cases, is performed under local anesthesia . When the wisdom tooth is fully included it is usually necessary to make a cut in the gum to access it. In addition, sometimes, it usually has to remove something from the bone that surrounds the tailpiece or split the wheel into fragments to facilitate its removal.

The postoperative period should not imply more than a swelling that will be reduced in two or three days and will require a soft diet and a hygiene according to the recommendations of the professional in the first week after the intervention.

Related Article: What Is A Wisdom Tooth?

Repositioning based on traction of the canines included

After the wisdom teeth, the fangs are the teeth that present the most problems of eruption. The most common cause in these cases is usually the lack of space in the arch or that the position of the tooth inside the bone is incorrect.

Unlike the wisdom teeth, the canines acquire great importance in the teeth as they are very strong teeth that help direct the movement of the occlusion . That is why, if the position of the canine is favorable, the most recommendable treatment is the repositioning of it in the dental arch through a combined intervention between the maxillofacial surgeon and the orthodontist.

The intervention in the case of the included canines requires the surgeon to make a small opening in the place where the tusk is retained (also called fenestration ), to allow the orthodontist to place a bracket or support that cooperates in pulling the tooth.

This intervention is also performed under local anesthesia and lasts between 20 and 25 minutes. Its postoperative period involves a slight edema and requires a soft diet for two or three days, after which the patient can begin his orthodontic treatment to help align the canine along with the rest of the arch.

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