Exposure of Impacted Teeth

• What is an impacted tooth?
• What happens if the eyetooth will not erupt when proper space is available?
• What to expect from surgery to expose & bracket an impacted tooth

What is an impacted tooth?

An impacted tooth simply means that it is “stuck” and cannot erupt into function. Patients frequently develop problems with impacted third molar (wisdom) teeth. These teeth get “stuck” in the back of the jaw and can develop painful infections, among a host of other problems (see Wisdom Teeth under Procedures). Since there is rarely a functional need for wisdom teeth, they are usually extracted if they develop problems. The maxillary cuspid (upper eyetooth) is the second most common tooth to become impacted. The cuspid tooth is a critical tooth and plays an important role in your “bite”. The cuspid teeth are very strong biting teeth and 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 cuspid teeth are the last of the “front” teeth to erupt into place. They usually come into place around age 13 and cause any space left between the upper front teeth to close tighter together. If a cuspid tooth gets impacted, every effort is made to get it to erupt into its proper position. 

What happens if the eyetooth will not erupt when proper space is available?

In cases where the eyeteeth will not erupt spontaneously, the orthodontist and oral surgeon will work together to get these teeth to erupt. Each case must be evaluated on an individual basis, but treatment will usually involve a combined effort between the orthodontist and the oral surgeon. The oral surgeon will expose and bracket the impacted eyetooth.

The goal is to erupt the impacted tooth and not to extract it. Once the tooth has moved into its final position, the gum around it will be evaluated. 

What to expect from surgery to expose & bracket an impacted tooth

The surgery to expose and bracket an impacted tooth is a very straightforward surgical procedure that is performed in the oral surgeon’s office. For most patients, it is performed using IV sedation. While the patient is asleep, we will expose the unerupted tooth and attach a bracket to the tooth with a chain attached to it. Upon waking up from surgery, the patient will find the chain tied to their braces and the site sutured close. Following surgery, they will return to their orthodontist to have the chain attached to a bracket and start the process of pulling the tooth into place.