ORTHODONTIC EXPOSURE / IMPACTED TEETH
An impacted tooth simply means that it cannot erupt into function. Patients frequently develop problems with impacted third molar (wisdom) teeth. These teeth get “stuck” in the back of the jaw and can develop painful infections, among a host of other problems. Since there is rarely a functional need for wisdom teeth, they are usually extracted if they develop issues. The maxillary canine is the second most common tooth to become impacted. The canine tooth is a critical tooth and plays an important role in your “bite”. They are designed to be the first teeth that touch when your jaws close together so they guide the rest of the teeth into the proper bite.
Normally, the maxillary canine teeth are the last of the “front” teeth to erupt into place. They usually come into place around age 13 and cause any space left between the upper front teeth to close tighter together. If a canine tooth gets impacted, every effort is made to get it to erupt into its proper position. The techniques involved to aid eruption can be applied to any impacted tooth in the upper or lower jaw, but most commonly they are applied to the maxillary canine teeth.
EARLY RECOGNITION IS KEY TO SUCCESSFUL TREATMENT
The older the patient, the more likely an impacted canine will not erupt by natural forces alone, even if the space is available for the tooth to fit in the dental arch. A panoramic x-ray or cone beam CT, along with a dental examination, will help determine whether all the adult teeth are present or if some adult teeth are missing.
In cases where the canine will not erupt spontaneously, the orthodontist and oral surgeon will work together to get these teeth to erupt. Each case must be evaluated on an individual basis, but treatment will usually involve a combined effort between the orthodontist and the oral surgeon. The oral surgeon will expose and bracket the impacted canine.
The goal is to erupt the impacted tooth and not to extract it. Once the tooth has moved into its final position, the gum around it will be evaluated. In some circumstances, there may be some minor “gum surgery” required.
WHAT TO EXPECT FROM SURGERY
The surgery to expose and bracket an impacted tooth is a very straightforward surgical procedure that is performed in the oral surgeon’s office. For most patients, it is performed using local anesthesia.
