Impacted Tooth Exposure

An impacted tooth is a tooth that is stuck beneath the gums and cannot erupt into the mouth the way it should.

Impacted teeth can cause an unstable bite and lead to costly orthodontic or restorative work later in life.

The Canadian Association of Orthodontists recommends that a dental examination with diagnostic images be performed on children by the age of seven to determine if there are problems with the eruption of the adult teeth.

Patients most commonly develop problems with impacted third molar (wisdom) teeth.

When these teeth get trapped beneath gum tissue and bone, they can develop painful infections and other problems. Since there is rarely a functional need for wisdom teeth, extraction by an oral surgeon is usually recommended. Other teeth, such as the canines, are generally not extracted but are treated orthodontically or surgically so that they can emerge successfully into the mouth.

Canine teeth may become impacted due to several reasons:

The canine teeth are the last primary (permanent) teeth to come in, emerging at about the age of 11 or 12, and they are very important for a proper bite.

The baby teeth do not fall out and block the eruption of the canines.

There’s not enough room in the mouth for them to emerge.

Unusual growths block the route of the tooth.

Dental crowding due to extra teeth (this is rare).

Your child’s dentist will recommend further treatment if an impacted tooth is suspected.

Dental professionals usually recommend that an impacted canine be surgically exposed as early as possible so that it has the best chance to grow into the dental arch on its own.

As with the wisdom teeth, without treatment, the roots of impacted canines can fuse with the jaw bone over time. This makes it less likely that these important teeth will emerge properly.

Exposure and Bonding for Impacted Canines

Most commonly, when there is an impacted canine tooth (also called an eyetooth if located in the upper jaw), orthodontic braces will be used to provide room for the tooth to move into its proper position. Once the space is ready, the orthodontist will refer the patient to the oral surgeon to have the impacted canine exposed and bracketed to help align the tooth as it erupts.

The surgery to expose and bracket an impacted tooth is a simple surgical procedure. For most patients, it is performed with intravenous (IV) sedation. This can be discussed in detail at your pre-operative consultation with your oral surgeon. During the procedure, the gum tissue will be lifted to expose the 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 small chain attached that will be used to guide the tooth into position over a few months’ time.