IMPACTED CANINES

Understanding Impacted Teeth

An impacted tooth is one that is unable to break through the gum line correctly. Often this is because there isn’t enough room for the tooth to emerge, but it can also happen when the tooth is in an awkward position, baby teeth are in the way, or cysts or tumors block its development.

Wisdom teeth are often impacted and are usually surgically removed because they aren’t necessary for proper function and can cause alignment problems and tooth decay.

Canine teeth, however, can become impacted too. Baby teeth may get in the way, or other teeth crowd the canine’s growth. Canine teeth are essential to alignment, bite, and oral function, so an expose and bond procedure helps encourage these teeth to grow properly.

Impacted Canines Surgical Procedure

Expose and bond combines oral surgery and orthodontics. Braces are placed on the teeth to create space for the impacted tooth. Once the space is clear, your surgeon exposes the impacted tooth in a minor surgical procedure. Then your provider bonds a bracket to the tooth along with a chain that uses gentle force to help guide the impacted tooth to its new place.

Why Treatment is Important

If the impacted tooth remains beneath the gum line, it can cause complications, including:

• Damage to the roots of nearby teeth
• Cyst formation
• Misalignments in nearby teeth

After a thorough dental exam that includes imaging tests to look at the placement of the impacted tooth, the providers at Oral Surgery Specialists of New York recommend the appropriate treatment, which often involves expose and bond.

Results

The impacted tooth moves gradually, so it may take up to a year to take its space. You’ll have regular check-ins at Oral Surgery Specialists of New York to ensure the process goes smoothly. The team makes any adjustments necessary during the course of your treatment so you end up with a healthy, aligned smile.

Treatment Timeline

Assessment and Diagnosis

An assessment by the dentist or orthodontist, including examination, radiographs, and sometimes special scans, determines the nature of the impaction. Upper canines are often impacted on the roof of the mouth, and occasionally, both upper and lower canines may be affected.

Collaborative Treatment Approach

Collaboration between the orthodontist and oral surgeon is crucial for effective treatment. Braces are placed by the orthodontist to create space for the impacted tooth, either before or after exposure. The oral surgeon performs a surgical procedure, exposing the impacted tooth, and attaches a mesh with a small gold chain using special glue.

Surgical Procedure

This surgery can be conducted under general anesthesia in a hospital or in a surgical suite, possibly with local anesthesia and intravenous sedation. The gum over the impacted tooth is lifted, exposing the canine by removing any obstructing bone. If a baby canine tooth is present, it is usually extracted. The mesh and chain are affixed, and the gum is mostly returned to its original position and sutured, leaving the chain visible.

Recovery Process

Following surgery, numbness in the area may persist for a few hours. Pain, manageable with mild analgesics, is expected and typically improves within a few days. The area remains tender for about a week, during which a soft diet is recommended. Mouthwashing is advised, while brushing the area is to be avoided. Orthodontic treatment can resume after 1-2 weeks.

Possible Complications

Occasionally, the glue attaching the chain to the tooth may fail, requiring a second small procedure for reattachment under local anesthesia. In rare cases, an impacted canine may be difficult to move due to its position or fusion to surrounding bone (ankylosed). In such instances, tooth removal might be necessary to facilitate orthodontic movement into the desired position.