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Anesthesiology159 papers

Failure of tooth eruption

Last edited: 4/15/2026

Overview

Failure of tooth eruption, also known as impaction, occurs when a tooth fails to erupt into the oral cavity due to obstruction or other anatomical or pathological reasons 1. This condition commonly affects third molars but can involve other teeth as well.

Diagnosis

  • Clinical examination to identify impacted teeth and assess for signs of infection or pain.
  • Radiographic imaging (orthopantomogram, CBCT) to confirm impaction and assess root development and surrounding structures 1.
  • Consideration of patient history regarding pain, swelling, and previous dental interventions 1.

    • Management

  • Surgical extraction as a primary treatment for symptomatic or problematic impacted teeth 1.
  • Orthodontic intervention for teeth that can be guided into proper alignment if feasible 1.
  • Conservative management with analgesics and antibiotics for associated infections 1.

    • Special Populations

  • Pediatrics: Management often deferred until skeletal maturity to allow for natural eruption; surgical intervention considered only if causing significant issues 1.
  • Elderly: Increased risk of complications; careful assessment and possibly conservative management preferred unless severe symptoms necessitate intervention 1.

    • Key Recommendations

  • Utilize radiographic imaging (orthopantomogram, CBCT) for definitive diagnosis of tooth impaction 1. (Evidence: Moderate)
  • Consider alternative anaesthetic techniques if conventional inferior alveolar nerve blocks fail, especially in cases with altered mandibular foramen anatomy 1. (Evidence: Expert opinion)
  • Prioritize surgical extraction for symptomatic impacted teeth, balancing patient symptoms and potential complications 1. (Evidence: Moderate)

    • References

    1 Holliday R, Jackson I. Superior position of the mandibular foramen and the necessary alterations in the local anaesthetic technique: a case report. British dental journal 2011. link

    Original source

    1. [1]
      Superior position of the mandibular foramen and the necessary alterations in the local anaesthetic technique: a case report. — Holliday R, Jackson I British dental journal (2011)
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