What is an impaction? If a tooth never comes through the gum tissue and is covered by tissue or bone it is referred as “being impacted.” To remove impacted teeth, the tissue must first be opened and often bone must be removed to get to the tooth. In order to keep the hole as small as possible, the teeth may be cut into several small pieces so each piece can be removed more easily. After this type of extraction, there is usually swelling and moderate to sever pain requiring potent pain killers for a few days