When a tooth does not fully erupt into the mouth, but remains below the gums, it is said to be impacted. Impacted teeth can present special health problems for most patients, and they are generally removed to prevent future difficulties. The extraction of such teeth proceeds like the surgical extraction explained above with a few modifications. Sometimes, the only surgical procedure is the raising of the soft tissue flap. If after raising the flap, the extraction can proceed as a simple extraction, the tooth is said to be a “tissue impaction” because there was enough of the crown left above the bone to grab and extract with forceps.

But many times the crown is submerged below the level of the bone. The tooth may even be lying on its side under the bone which complicates the extraction further. In these cases, not only must the dentist remove surrounding bone in order to expose the tooth, but he must cut and break the tooth itself into sections so that each section can be removed separately. Teeth in this condition are said to be “bony impactions” and are further classified as vertical, horizontal or angular depending on the angle of the tooth under the bone.