Embedded Tooth

A tooth that does not emerge through the gum as expected is an unerupted tooth. Extraction of an unerupted tooth can involve bleeding, infection, nerve injury or delayed healing.

The distinction is important: an impacted tooth is held back by a physical barrier, while an embedded tooth has no obstruction along its route and mainly lacks sufficient eruptive force.

A submerged tooth has already erupted but becomes ankylosed and cannot keep erupting as the jaws grow. Primary failure of eruption is a partial or complete failure after the eruption path has formed.

Some medicines that inhibit the prostaglandin pathway may slow tooth eruption. Prolonged malnutrition associated with childhood vitamin deficiencies also correlates with delayed eruption, as do several syndromes.

Assessment of an unerupted tooth includes deciding whether there is a physical obstruction, because that separates an impacted tooth from an embedded one. Imaging may be needed before surgery when displacement is suspected.

Surgical extraction of an unerupted tooth can include raising a flap, removing bone, sectioning the tooth and placing sutures. The approach is planned around the tooth and nearby anatomy.

Treatment depends on which tooth has failed to erupt, where it lies, and whether it is affecting oral health or the bite. Early diagnosis can prevent more complicated problems later.

Possible complications of extracting an unerupted tooth include bleeding, infection, nerve injury and delayed healing. Local anaesthetic injection can also cause nerve injury, with neurotoxicity believed to contribute more than direct needle trauma.

A tooth that is not coming in as expected can be identified early. A planned approach may prevent later problems when the tooth is affecting oral health or the bite.