What Is an Impacted Tooth?
An impacted tooth is a tooth that is stuck in the gum, unable to erupt and provide normal function. Impacted wisdom teeth can cause issues, such as pain and infection. Because wisdom teeth are not needed, they are often extracted.
The maxillary cuspid (known as the “upper canine”) is another tooth prone to impaction. This tooth, however, is critical for bite functions. The upper canines are often the last “front” teeth to erupt (typically around the age of 13). If eruption seems to be delayed, an oral surgeon can use techniques to encourage the tooth to advance.
For Best Outcomes, Early Recognition Is Important
As patients age, it becomes increasingly less likely that impacted canines will erupt on their own. That’s why the American Association of Orthodontists recommends all patients undergo a panoramic x-ray and dental examination at around the age of seven in order to evaluate potential issues with the eruption of adult teeth. This exam, typically done by a general dentist or hygienist, can confirm the presence of all adult teeth.
Braces may be recommended to create space for normal eruption of adult teeth. Or, extraction of baby teeth or certain adult teeth may be recommended to allow room for the critical canines.
By age 11-12, an eruption path should be created so that impacted canines can move in. It’s important to create space early, as later in life the impacted canines may be fused in place. In such circumstances, extraction and replacement is the only option.
What If The Canine Will Not Erupt … Even When There Is Room?
In some cases, canines will not erupt despite there being enough room. In such cases, Dr. Coyne may work with the patient’s orthodontist on a strategy to create space and promote eruption. Once the space has been created, Dr. Coyne can expose and bracket the impacted canine.
This is a simple in-office procedure in which an orthodontic bracket is bonded to the exposed tooth. A small gold chain connecting the bracket and orthodontic arch wire will help guide the tooth down.
Approximately one to 14 days after surgery, patients return to the orthodontist to have a rubber band attached to the chain. The band creates a light force on the impacted tooth, drawing it into place in the dental arch. This slow process can take up to a year to complete. Once the formerly impacted tooth is in the proper spot, the surrounding gum is evaluated and healing begins.
What to Expect: Surgery, Exposure & Bracketing An Impacted Tooth
The surgery to expose an impacted tooth is a very common in-office procedure done under intravenous sedation. The surgery takes approximately 75 minutes (one tooth) or 105 minutes (both sides).
Expect some bleeding at the surgical sites following your procedure. Advil or Tylenol is typically sufficient for managing postoperative pain. After two to three days, most patients do not require any pain medication. Some swelling of the lip is normal, but can be managed with ice packs the afternoon after the procedure.
Eat a diet of soft foods at first and resume a normal diet as soon as you feel comfortable. You will have an appointment to return to see Dr. Coyne approximately seven to ten days after surgery. See your orthodontist one to 14 days after the procedure to activate the eruption process (connecting the rubber band to the chain).
Should you have any after-hours questions or concerns, call Coyne Oral Surgery at 615-771-0017.