Exposure and Bracketing of Impacted Teeth

An impacted tooth simply means that it is “stuck” and cannot erupt into function. The maxillary (upper jaw) canine is the second most common tooth to become impacted (after the wisdom teeth.) The canine tooth is a critical tooth in the dental arch and plays an important role in your bite. The canine teeth are very strong biting teeth, which have the longest roots of any human teeth. 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 12 and cause any space left between the upper front teeth to close tight together. If a canine tooth gets impacted, every effort is made to get it to erupt into its proper position in the dental arch. The techniques involved to aid eruption can be applied to any impacted tooth in the upper or lower jaw.

How do You Know if a Tooth is Impacted?

When an adult tooth doesn’t erupt, a panoramic x-­‐ray helps to determine if there is a problem with eruption or if the tooth is impacted. It may be necessary to have a CT (iCAT) 3-D scan to determine the exact location of the “missing” tooth.

How is an Impacted Canine Tooth Treated?

Treatment of an impacted canine may involve an orthodontist placing braces to open spaces to allow for proper eruption of the adult teeth. Treatment may also require extraction of over-retained baby teeth and/or selected adult teeth that are blocking the eruption of the all important canine.

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, naturally. If the canine is allowed to develop too much (age 13-14), the impacted canine may not erupt by itself even with the space cleared for its eruption.

When the tooth refuses to erupt on its own the orthodontist and oral surgeon work together to get these un-­erupted canines moved into a proper position. In a surgical procedure performed in the office, the gum and bone on top of the impacted tooth will be lifted up to expose the hidden tooth underneath. If there is a baby tooth present, it will be removed at the same time. Once the tooth is exposed, the oral surgeon will bond an orthodontic bracket to the exposed tooth. The bracket will have a miniature chain attached to it. The orthodontist will use this chain to put a light eruptive pulling force on the impacted tooth. This will begin the careful process of moving the tooth into its proper place.

 

If you have questions or concerns about dental emergencies, please contact our staff at Santa Rosa Oral Surgery or just set up an appointment.