Impacted Molar

Molars are the teeth in the back of your mouth. You have 12 molars. There are 6 molars in each jaw, 3 on each side. When they grow in (erupt) they sometimes cause problems. Molars trapped inside the gum are impacted molars. Impacted molars may grow sideways, tilted, or may only partially emerge.

Molars erupt at different times in life. The first set of molars usually erupts around 6 to 7 years of age. The second set of molars typically erupts around 11 to 13 years of age. The third set of molars are called wisdom teeth. These molars usually do not have enough space to erupt properly. Many teens and young adults develop impacted wisdom teeth and have them surgically removed (extracted). However, any molar or set of molars may become impacted.

CAUSES

Teeth that are crowded are often the reason for an impacted molar, but sometimes a cyst or tumor may cause impaction of molars.

SYMPTOMS

Sometimes there are no symptoms and an impacted molar is noticed during an exam or X-ray. If there are symptoms they may include:

  • Pain.

  • Swelling, redness, or inflammation near the impacted tooth or teeth.

  • Stiff jaw.

  • General feeling of illness.

  • Bad breath.

  • Gap between the teeth.

  • Difficulty opening your mouth.

  • Headache or jaw ache.

  • Swollen lymph nodes. 

Impacted teeth may increase the risk of complications such as:

  • Infection, with possible drainage around the infected area.

  • Damage to nearby teeth.

  • Growth of cysts.

  • Chronic discomfort.

DIAGNOSIS

Impacted molars are diagnosed by oral exam and X-rays.

TREATMENT

The goal of treatment is to obtain the best possible arrangement of your teeth. Your dentist or orthodontist will recommend the best course of action for you. After an exam, your caregiver may recommend one or a combination of the following treatments.

  • Supportive home care to manage pain and other symptoms until treatment can be started. 

  • Surgical extraction of one or a combination of molars to leave room for emerging or later molars. Teeth must be extracted at appropriate times for the best results.

  • Surgical uncovering of tissue covering the impacted molar.

  • Orthodontic repositioning with the use of appliances such as elastic or metal separators, braces, wires, springs, and other removable or fixed devices. This is done to guide the molar and surrounding teeth to grow in properly. In some cases, you may need some surgery to assist this procedure. Follow-up orthodontic treatment is often necessary with impacted first and second molars.

  • Antibiotics to treat infection.

HOME CARE INSTRUCTIONS

Rinse as directed with an antibacterial solution or salt and warm water. Follow up with your caregiver as directed, even if you do not have symptoms. If you are waiting for treatment and have pain:

  • Take pain medicines as directed.

  • Take your antibiotics as directed. Finish them even if you start to feel better.

  • Put ice on the affected area.

  • Put ice in a plastic bag.

  • Place a towel between your skin and the bag.

  • Leave the ice on for 15-20 minutes, 03-04 times a day.

SEEK DENTAL CARE IF:

  • You have a fever.

  • Pain emerges, worsens, or is not controlled by the medicines you were given.

  • Swelling occurs.

  • You have difficulty opening your mouth or swallowing.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.