Surgical Orthodontic Assistance

Impacted Canines

An impacted tooth means that a tooth is “stuck” and cannot erupt into function. Patients frequently develop problems with impacted third molar (wisdom) teeth, such as the development of painful infections. These teeth are generally not needed and can be removed. The maxillary cuspid (upper eyetooth) is the second most common tooth to become impacted and is critical in the role it plays in your “bite”. These teeth are very strong biting teeth and are the first teeth to touch when your jaw closes, thus every effort is made to get the teeth to erupt into their natural position.


Early Recognition of Impacted Eyeteeth Is The Key To Successful Treatment

An impacted tooth is less likely to erupt by natural force in older patients. The American Association of Orthodontists recommends a panorex screening x-ray, along with a dental examination, for children around the age of 7. This ensures there are no problems with the eruption of adult teeth. The x-ray and examination is usually be performed by a dentist or hygienist, who may refer you to an orthodontist or oral surgeon. Treatment for impacted teeth includes using braces to open up spaces between teeth allowing for eruption of eyeteeth and removing over-retained baby teeth that are blocking the eruption of eyeteeth.


What Happens If The Eyetooth Will Not Erupt When Proper Space Is Available?

In cases where the eyeteeth will not erupt naturally, an orthodontist and oral surgeon will work together to help these unerupted eyeteeth erupt. The orthodontist, in most cases, will place braces on the teeth to create a space for the impacted tooth to be moved into proper position. Once the space is available, an oral surgeon will have the impacted eyetooth exposed and bracketed.

In a simple surgical procedure, the top gum of the impacted tooth will be lifted to expose the hidden tooth. If a baby tooth is present, it will be removed. Otherwise, the surgeon will bond an orthodontic bracket to the exposed tooth. A chain will be attached to the bracket and in some cases the gum covering the tooth may be moved for better access to the tooth.

Within two weeks of surgery, the patient will return to the orthodontist. The orthodontist will attach the chain to a rubber band, which will put a light pulling force on the impacted tooth. This will begin the process of moving the tooth into its proper place.

Once the tooth is in its final position, the gum around it will be evaluated to make sure it is strong and healthy enough to last for a lifetime of chewing and brushing. Early identification of impacted eyeteeth is beneficial, as treatment should be initiated at a younger age. Once the general dentist or hygienist identifies a potential eruption problem, the patient will be referred to an orthodontist or oral surgeon. They will then perform an evaluation and recommend the best course of action.


What To Expect From Surgery To Expose & Bracket An Impacted Tooth

The surgery to expose and bracket an impacted tooth is very straightforward. Surgery will be performed in the oral surgeon’s office under laughing gas, local anesthesia, and in some cases IV sedation. The procedure takes around 75 minutes for one tooth and 105 minutes for both sides. These issues will be discussed in detail with your doctor at your preoperative consultation.

Refer to Preoperative instructions under surgical instructions to review any details.

Patients can expect limited bleeding after surgery but some discomfort including possible swelling and bruising. Ice packs and inflammatory medicine like Advil are usually enough to manage any pain. A soft, bland diet is recommended after surgery, and a normal diet may be resumed when chewing is comfortable. A postoperative evaluation with your doctor is recommended seven to ten days after surgery. This will ensure the healing process is on track and you are maintaining good oral hygiene. Also, expect to visit your orthodontist within 14 days to activate the eruption process by applying rubber bands to the chain in your mouth.


The doctor is always available, at the office or over the phone, if any problems should arise after surgery. Simply call the Oral and Facial Surgery Center of Puyallup at (253) 445-0022) if you have any questions.