This document discusses food impaction, including its causes, types, mechanisms, signs and symptoms, detection, and management. Food impaction occurs when food becomes forcefully wedged between teeth or in the gingiva. It is often caused by factors like uneven tooth wear, missing teeth, or poor restorations. Left untreated, food impaction can lead to inflammation, bone loss, and tooth mobility. Detection involves examining contacts, using dental floss or casts. Management includes nonsurgical treatments like cleaning and occlusal adjustment, as well as restoring proper contacts and replacing missing teeth.

1. FOOD IMPACTION AND TREATMENT
NANDANA S BABU
THIRD YEAR BDS

2. CONTENTS
• INTRODUCTION
• TYPES OF FOOD IMPACTION
• MECHANISM OF FOOD IMPACTION
• FACTORS CAUSING FOOD IMPACTION
• SEQUELAE OF FOOD IMPACTION
• SIGNS AND SYMPTOMS
• DETECTION OF FOOD IMPACTION
• MANAGEMENT
• CONCLUSION

3. INTRODUCTION
 Food impaction is defined as forceful wedging of
food into the periodontium.

4.  It is caused by:
• anatomy related,
• inadequate interproximal restoration ,
• prosthetic related
• implant related factor

5.  Anatomic related factors include:
1) diastema,
2) tooth movement ,
3) occlusion discrepancy,
4) interdental papilla support or recession.

6.  Inadequate interproximal restoration due to
inappropriate design of marginal ridges and contact
area.

7.  Prosthetic related factors like:
a) proximal filling related,
b) fractured restoration,
c) inadequate prosthetic crown ,

8. d) faulty design impression or laboratory
procedure fabrication ,
e) fracture of prosthesis at proximal
contact

9.  Implant related factors are :
• excessive distance between implant /
implant and adjacent tooth
• inappropriate distance between contact
point and alveolar bone crest

10. FOOD IMPACTION
• Is the forceful wedging of food into the periodontium
by occlusal forces.
• It may occur interproximally or in relation to the
facial or lingual tooth surfaces .

11. • Is very common cause of gingival inflammation .
• Failure to recognize and eliminate food impaction is
responsible for the unsuccessful outcome of an
otherwise thoroughly treated case of periodontal
disease

12. • TYPES OF FOOD IMPACTION
1. Vertical impaction
by occlusal forces
2. Lateral food impaction
by pressure from tongue ,cheek, lip

13. LATERAL FOOD IMPACTION
• May occur when gingival embrassure is
enlarged by tissue destruction in periodontal diseases or
by recession.
• Food impaction results when food forced into such
embrassure are retained instead of passing through that
embrassure.

14. INTERPROXIMAL FOOD IMPACTION
GINGIVAL EMBRASSURE ENLARGED
Lateral pressure from lip, cheek and tongue.
PERIODONTAL DISEASE
Tissue destruction Gingival recession

15. MECHANISM OF FOOD IMPACTION
• Forceful wedging of food is prevented by :
I. Integrity and location of proximal contact.
II. Contour of marginal ridge and developmental grooves.
III. Contour of facial and lingual surfaces.
IV. An intact, firm proximal contact relationship prevents
the forceful wedging of food inter-proximally.

16. • The location of the contact is also important in
protecting the tissues against food impaction.
• The optimal cervico-occlusal location of the contact is
at the longest mesiodistal diameter of the tooth , close
to the crest of the marginal ridge.

17. • The proximity of the contact point to the occlusal
plane reduces the tendency towards food impaction in
the smaller occlusal embrassure.
• The absence of contact or the presence of an
unsatisfactory proximal relationship is conducive to
food impaction

18. • The contour of the occlusal surface estabilished by
the marginal ridges and related developmental
grooves normally serves to deflect food away from
the interproximal spaces.

19. • As the teeth wear down and flattened surfaces replace
the normal convexities, the wedging effect of the
opposing cusp into the interproximal space is
exaggerated and food impaction results.

20. • Cusps that tend to forcibly wedge food
interproximally are known as plunger cusps .
• The plunger cusp effect may occur with wear , as
indicated, or may be the result of a shift in tooth
position following failure to replace missing teeth.

21. Wedging effect upon
food bolus that results
from wearing away of
normal occlusal
convexities
And protective marginal
ridges
Food impaction
corrected by restoring
Occlusal convex surfaces
And marginal ridges and
Directing food into
The occlusal surface

22. • Excessive anterior overbite is a common cause.
• Forceful wedging of food into gingival surfaces of
mandibular anterior teeth and the lingual surfaces of
the maxillary teeth produces varying degrees of
periodontal involvement.

23. • Gingival changes in the mandibular anterior region,
due to excessive anterior overbite - easily detectable.

24. • However the effects of food impaction on the lingual
surface of the maxilla are often overlooked.
• Inflammation caused by lingual food impaction may
spread to the contiguous facial gingival margin.

25. • Possibility that lingual food impaction may be
contributory factor should always be explored when
the etilogy of gingival disease in anterior maxilla is
being considered.

26. • A classic analysis of the factors leading to food impaction
has been made by Hirschfeld (1928) . He recognised
the following factors:
1.Uneven occlusal wear
2.Opening of the contact point as a result of loss of
proximal support or from intrusion.

27. • Congenital morphological abnormalities and
improperly constructed restorations.

28. • A.removal of maxillary
third molar permits
second molar to be
forced distally when
teeth contact in occlusion
B. Bolus of food forced
interproximally
as maxillary second molar is
wedged distally

29. • However the presence of the previously mentioned
abnormalities does not necessarily lead to food
impaction and periodontal diseases.

30. • A study of interproximal contacts and marginal ridges
relationships in three group of periodonyally healthy
males revealed that from 61.7 to 76 % of the proximal
contacts were defective and that 33.5 % of adjacent
marginal ridges were uneven

31. Lateral food impaction :
 In addition to food impaction that is due to occlusal
forces, lateral pressure from the lips, cheeks and
tongue may force food interproximally.

32.  This is more likely to occur when the gingival
embrassure is enlarged by tissue destruction in
periodontal disease or by recession; into this
embrassure during mastication , food is retained
instead of passing through.

33.  According to Hirschfield, food impaction can occur in
the following conditions.
• Class I : UNEVEN OCCLUSAL WEAR
 Can lead to food impaction because deflection of food
away from the proximal areas doesnot occur.

34.  Subdivided into 3:
o TYPE A: wedging action produced by transformation
of occlusal convexities into oblique facets ,
exaggerating the action of plunger cusps.

35. o TYPE B: remaining obliquely worn cusp of a
maxillary tooth overhanging the distal surface of its
functional anatagonists.

36. o TYPE C: obliquely worn cusp of a mandibular tooth
overhanging the distal surface of its functional
antagonists

37. • CLASS II : LOSS OF PROXIMAL CONTACT
 this is one of the most common cause for food
impaction. It may due to periodontal disease, non-
replaced missing teeth, proximal caries and abnormal
biting habits.

38.  Subdivided into 4 :
o TYPE A: loss of distal support through the removal of
a distally adjacent tooth.
o TYPE B: loss of mesial support due to extraction of
mesial tooth

39. o TYPE C: oblique drifting due to non replacement of a
missing tooth.
o TYPE D : permanent occlusal openings to interdental
spaces:
i. Drifting after extraction of adjacent tooth.

40. ii. Habit of forcing teeth out of position.
iii. Periodontal diseases.
iv. Caries.

41. • CLASS III : EXTRUSION BEYOND THE
OCCLUSAL PLANE.
Extrusion of a tooth which was previously retaining
with the adjacent mesial and distal teeth result in
occlusal step deformity between marginal ridges of
extruded and non intruded teeth.

42. • CLASS IV : CONGENITAL MORPHOLOGIC
ABNORMALITIES OF TEETH.
Any congenital morphologic abnormalities in size ,
shape , form and position of tooth leads to open
proximal contact and food impaction.

43. • Subdivided :
o TYPE A: position of a tooth in torsion .
o TYPE B: emphasized embrassures between thick
neck teeth.

44. • TYPE C: faciolingual tilting.
• TYPE D : improperly constructed cantilever
restoration.
• TYPE E : scalloped cervical bevels on the tissue
borne areas of prosthetic restorations

45. SEQUELAE OF FOOD IMPACTION
Food impaction serves :
• to initiate gingival and periodontal disease .
• aggrevates the severity of pre-existent pathological
changes.

46. Signs and symptoms associated with food impaction are:
• Feeling of pressure
• Urge to dig the material from between the teeth
• Vague pain radiating deep in the jaws
• Gingival inflammation with bleeding
• Gingival recession

47. • Periodontal abcess formation
• Destruction of alveolar bone.
• Root caries

48. • Varying degrees of:
a. Inflammatory involvement of the PDL
with an associated elevation of tooth in its
socket.
b. Prematurity in functional contact.
c. Sensitivity to percussion.

49. SEQUALAE FOLLOWING LOSS OF PROXIMAL CONTACT
BONE LOSS AND TOOTH MOBILITY
POCKET FORMATION
GINGIVAL INFLAMMATION
FOOD IMPACTION
LOSS OF PROXIMAL CONTACT RELATIONSHIPS

50. SIGNS AND SYMPTOMS
• Discomfort
-feeling of pressure
-vague pain
-root caries
• Periodontal changes
-gingival inflammation
-bleeding
-gingival recession

51. DETECTION OF FOOD IMPACTION
check proximal contact relation
-clinical observation
-X-rays
-dental floss
-dental casts
• Look for plunger cusps

52. MANAGEMENT
• PERIODONTAL TREATMENT
a. scaling and root planing

53. b. flossing

54. c. interproximal brushing

55. d. curettage

56. • OCCLUSAL ADJUSTMENT
a. adjusting plungers cusp
b. levelling of occlusal height of marginal
ridges

57. • RESTORING AN IDEAL CONTACT
• PERMANENT RESTORATION

58. CONCLUSION
• An intact proximal contact relationship, prevents
forceful wedging of food interproximally.
• The proximity of the contact point to the occlusal
plane reduces the tendency towards food impaction in
the smaller occlusal embrassure.

59. • Proper restoration by restoring the contour and
contact points of tooth can help to prevent food
impaction in certain patients.