Impacted Teeth: Etiology, Diagnosis, and Management Introduction Tooth impaction is a common dental condition in which a tooth fails to erupt into its normal functional position within the expected period. It most frequently affects the mandibular and maxillary third molars, followed by the maxillary canines. Impacted teeth may remain asymptomatic for extended periods or cause complications affecting oral health and the surrounding structures. Therefore, accurate diagnosis and appropriate treatment planning are essential for effective clinical management. Etiology Tooth impaction may result from several local and systemic factors. Insufficient space within the dental arch is one of the most common causes, preventing the tooth from erupting normally. Other contributing factors include abnormal tooth positioning, premature loss or prolonged retention of primary teeth, supernumerary teeth, and pathological conditions such as cysts or tumors. Genetic predisposition and disturbances in normal dental development may also influence eruption patterns and contribute to impaction. Clinical Features and Complications Impacted teeth are frequently asymptomatic and may be discovered during routine dental examinations or radiographic investigations. However, some patients experience pain, swelling, tenderness, and inflammation of the surrounding soft tissues. Partially erupted third molars are particularly associated with pericoronitis, an inflammatory condition resulting from bacterial accumulation around the tooth crown. Other potential complications include dental caries, periodontal defects, root resorption of adjacent teeth, and the development of dentigerous cysts. These complications emphasize the importance of appropriate clinical assessment and radiographic evaluation to identify potential risks and determine the most suitable management strategy. Diagnosis The diagnosis of impacted teeth involves comprehensive clinical examination and appropriate radiographic investigations. Clinical assessment includes reviewing the patient’s symptoms, eruption history, oral hygiene, and the condition of the surrounding tissues. Panoramic radiography is commonly used to evaluate the position, angulation, and depth of the impacted tooth and its relationship with adjacent teeth and anatomical structures. Cone-beam computed tomography (CBCT) may be indicated in selected cases when three-dimensional information is required for accurate treatment planning, particularly when evaluating the relationship between impacted teeth and important anatomical structures. Management The management of impacted teeth depends on the patient’s age, symptoms, tooth position, and the presence of associated pathology. Asymptomatic teeth without evidence of disease may be managed through regular clinical and radiographic monitoring when appropriate. Surgical extraction may be indicated when an impacted tooth causes recurrent infection, persistent pain, caries, periodontal damage, or other pathological changes. For impacted permanent canines, surgical exposure combined with orthodontic traction may help guide the tooth into its correct position. Treatment decisions should be individualized, considering the potential benefits and risks of intervention. Conclusion Impacted teeth represent an important clinical concern because they may cause pain, infection, and damage to adjacent structures. Comprehensive examination, appropriate radiographic assessment, and individualized treatment planning are essential for achieving favorable outcomes. Early detection and regular follow-up can help prevent complications and support long-term oral health. References 1. Hupp, J. R., Ellis, E., & Tucker, M. R. Contemporary Oral and Maxillofacial Surgery. Elsevier. 2. Peterson, L. J., Ellis, E., Hupp, J. R., & Tucker, M. R. Contemporary Oral and Maxillofacial Surgery. Mosby. 3. National Institute for Health and Care Excellence (NICE). Guidance on the Extraction of Wisdom Teeth. Technology Appraisal Guidance TA1, 2000.