An impacted tooth simply means that it is “stuck” and cannot erupt into function. Patients frequently develop problems with impacted third molar (wisdom) teeth. Since wisdom teeth are usually not needed, they are most often extracted. The canine (eyetooth) is the second most common tooth to become impacted. Unlike the wisdom tooth, the canine tooth is a critical tooth in the dental arch and plays an important role in your “bite”. 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. If a canine tooth gets impacted, every effort is made to get it to erupt into its proper position in the dental arch.
Early Recognition Is Key To Successful Treatment
The older the patient the more likely an impacted canine will not erupt by natural forces alone, even if the space is available for the tooth to fit in the dental arch. This is why it is critical to treat these “missing teeth” as soon as they are discovered.
TREATMENT IS USUALLY REQUIRED
Often your orthodontist will be able to create sufficient space by moving teeth to allow the impacted canine to come into the mouth. However it is not uncommon to require a minor surgery to help these teeth come down even after the space is created for them.
In these cases, you will be referred to our experienced oral surgeons at OMSA for extraction of over-retained baby teeth and/or selected adult teeth that are blocking the eruption of the all-important canines. We will also need to determine if there is anything preventing the movement of the tooth into the mouth (curved roots, insufficient space, extra teeth blocking etc…)
At OMSA, we evaluate impacted canines with a clinical exam in combination with a 3D X-ray (CT Scan) that is conveniently done in our office. Both the exam and the X-ray help to determine where the impacted tooth is located in the jaw and if there are any barriers to the tooth being moved into the mouth.
In a simple surgical procedure performed in our office under light anesthesia, the gum on top of the impacted tooth will be lifted up to expose the hidden tooth underneath. Once the tooth is exposed, the oral surgeon will bond an orthodontic bracket to the exposed tooth. The bracket will have a miniature gold chain attached to it. The oral surgeon will guide the chain back to the orthodontic/braces wire where it will be temporarily attached. Sometimes the surgeon will leave the exposed and impacted tooth completely uncovered by suturing the gum up high above the tooth, or making a window in the gum covering the tooth. Most of the time the gum will be returned to its original location and sutured back with only the chain remaining visible as it exits a small hole in the gum. 1-2 weeks after surgery you can return to your orthodontist to have the tooth slowly and painlessly pulled into place.
WHAT HAPPENS IF THE CANINE CANNOT NOT ERUPT
For many reasons, some impacted teeth are not able to be moved into the mouth. Clinical and radiographic evaluation often allow us to identify which teeth are unlikely to be successfully moved. In this case your surgeon and orthodontist will discuss with you the best option for moving you forward.
In rare cases, an impacted tooth will not budge despite all the efforts of the orthodontist and oral surgeon to erupt it into place. The only option at this point is to extract the impacted tooth and consider an alternate treatment to replace it. If there is sufficient space and bone this is usually done with a dental implant. Your dentist, surgeon and orthodontist will work together to find the best option for you.
As always, your doctor is available at the office and can be contacted after hours if any problems should arise after surgery. Simply call our team at Charleston, SC Phone Number 843-554-5003 if you have any questions.