Orthodontic Exposure

An impacted tooth simply means that it is blocked, stuck, or unable to fully erupt and function properly. Wisdom teeth are the most common teeth to suffer impaction, but since they serve no important function, the typical treatment is to have them removed before they cause any problems (see Wisdom Teeth). However, other teeth in the mouth, which are more important to oral function, can also become impacted. Of these teeth the most common are the upper canines (eye teeth). Normally, the canine teeth are the last of the "front" teeth to erupt into place, at around age 13. If a canine tooth gets impacted, every effort is made to save the tooth and bring it into a normal position in the mouth.

Early recognition of impaction is the key to successful treatment
The primary reasons why canine teeth become impacted include; the presence of extra teeth or unusual growths that blocks or restricts the eruption path of the canine tooth, and overcrowding do to extra teeth or the misalignment of the front teeth. That's why the American Association of Orthodontists recommends that a Panorex screening x-ray and a dental examination be performed on all dental patients at age 7 to count the teeth and determine if any of these problems exist.

Treating these types of problems may involve an orthodontist placing braces to open spaces to allow for proper eruption of the adult teeth. Treatment may also require a surgical extraction of baby teeth and/or selected adult teeth that are blocking the path of the canine. Your oral surgeon will also need to remove any extra teeth or growths that are in the way. If the eruption path is cleared and the space is opened up by age 11 or 12, there is a good chance the impacted canine will erupt on its own. If the impacted tooth is allowed to develop too long (age 13-14), it will not erupt by itself even with the space cleared. If the patient is too old (over 40), there is a much higher chance the tooth will be fused in position. When fused, the only option is to extract the impacted tooth and replace it with a dental implant or a fixed bridge.

Exposure & Bracketing Procedure
Once your orthodontist has placed braces to open a space for the impacted tooth, Dr. Bachoura will expose and bracket the tooth in a simple surgical procedure performed under local anesthesia in our office. A small incision is made in the gum to expose the impacted tooth. An orthodontic bracket is bonded to the tooth and a gold chain is attached to the bracket, sutures are then placed to reposition the gum tissue.

Shortly after surgery (1-14 days) the patient will return to the orthodontist who will attach the chain to the existing orthodontic wire and will intermittently tighten it to guide the impacted tooth into its proper place in the dental arch. This is a carefully controlled, slow process that may take up to a year to complete. Recovery from this procedure is usually uneventful with only mild discomfort and swelling.