Exposure of an Impacted Tooth

In children, unerupted teeth that become impacted usually require surgical exposure to help them erupt. While the upper canines are the second most common teeth to become impacted after wisdom teeth, incisor teeth and premolar teeth can also become impacted.

Why are canine teeth important?

The canine teeth are critical teeth in the dental arch and they play an important role in your “bite” or occlusion, and they are also important for appearance. They are designed to be the first teeth that meet when your jaws close together so they guide the remaining teeth into the proper bite. For this reason, orthodontists work with oral surgeons to get impacted canines to erupt.

What can be done surgically for impacted canine teeth?

Each case is evaluated on an individual basis, but treatment usually involves a team effort between the orthodontist and oral surgeon. The surgical options include:

  1. Removed and discarded – this can be the treatment of choice if the impacted tooth is in a poor position for the orthodontic repositioning, or shows signs of causing problems to adjacent teeth. The resultant gap is filled with a false tooth such as an implant or bridge.
  2. Surgically exposed – this can be an option if the impacted tooth is in reasonable alignment and the patient is prepared to have orthodontic treatment for approximately 2 years.

The orthodontist usually places braces on the teeth first and a space is opened to provide room for the impacted canine tooth to be moved into the proper position. The orthodontist will then refer the patient to the oral surgeon to have the impacted canine tooth exposed.

The exposure of the tooth involves an operation where some gum tissue and bone overlying the tooth is removed, resulting in the crown of the tooth being exposed. Depending on the individual case, the oral surgeon might place a dressing over the tooth, which is held with stitches that are removed after 10 – 14 days. This allows the orthodontist to begin treatment for repositioning the tooth. Alternatively, the oral surgeon will bond an orthodontic bracket and gold chain onto the exposed tooth and the patient will return to the orthodontist to have the tooth repositioned into its proper place in the dental arch. The orthodontic repositioning process is a slow and carefully controlled manoeuvre that may take up to 1 year to complete.

canine exposure and eruption