Exposure of Impacted Teeth

What is an impacted tooth?

An impacted tooth simply means that the tooth is “stuck” and cannot erupt into function. Patients frequently develop problems with impacted wisdom teeth. These teeth get “stuck” in the back of the jaw and can develop painful infections as well as a host of other problems (see Wisdom Teeth under Procedures). Since there is rarely a functional need for wisdom teeth, they are usually extracted if they develop problems. The upper canines (a.k.a. cuspids or eyeteeth) are the second most common teeth to become impacted. The canines are critical teeth in the dental arch and play an important role in your bite. The canines are very strong and have the longest roots of any teeth in the human mouth. When closing your jaws together, canines are the first teeth to touch and therefore guide the rest of the teeth into the proper bite.

Normally, the upper canines are the last of the front teeth to erupt into position. 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 is 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 upper canines. Sixty percent of impacted upper canines are located on the palatal (roof of the mouth) side of the dental arch. The remaining impacted canines are found in the middle of the supporting bone, or are out to the facial side of the dental arch.

Treatment of Impacted Canines

Treatment of impacted canines may require referral to an oral surgeon for extraction of over-retained baby teeth and/or select adult teeth that are blocking the eruption of the all-important canines. The oral surgeon may also need to remove any extra teeth (supernumerary teeth) or growths that are blocking the eruption of any adult teeth.

In cases where the canines will not erupt spontaneously, the orthodontist and oral surgeon will usually work together to facilitate their eruption. Typically this involves surgical exposure and bracket placement by the oral surgeon, followed by gentle traction on the tooth over several months by the orthodontist to bring it into place. 

Exposure and Bracketing of an Impacted Cuspid

What to expect from surgery to expose & bracket an impacted tooth

The surgery to expose and bracket an impacted tooth is a very straightforward procedure that is performed in our office by either of our surgeons. For most patients, this procedure is performed under IV anesthesia and takes 1-2 hours to complete, depending on the complexity. Dr. Weber and Dr. Shepherd will evaluate your individual case and discuss its specific details prior to your procedure.