Impacted Canines

Impacted Canines

An impacted tooth is essentially a tooth that’s unable to properly emerge and function. The upper canine, also known as the upper eyetooth, is the tooth most frequently subject to this condition after wisdom teeth. These canines are essential for a healthy dental structure and have a significant role in how your bite functions. 

Typically, upper canines are the last front teeth to come in, usually appearing around the age of 13. They help to close any remaining gaps between the upper front teeth. When a canine becomes impacted, various techniques are employed to encourage it to emerge into its correct position. These methods can be used for any impacted tooth in either the upper or lower jaw, but they are most commonly used for the upper canine. 

Early Recognition Of Impacted Canines Is The Key To Successful Treatment

As a person ages, the likelihood that an impacted canine will naturally emerge decreases, even if there is enough room in the dental arch. The American Association of Orthodontists advises that by the age of seven, children should have a panorex screening x-ray and a dental check-up to assess the number and condition of their teeth. This helps to identify if any adult teeth are missing if extra teeth are present, or if there are any other obstructions that could affect the canine’s emergence. Usually, a general dentist or dental hygienist performs this examination and will refer you to an orthodontist if any issues are found. Treatment may involve braces to create space for the adult teeth to emerge or may require surgical intervention to remove any obstructions. 

 

If the path for the canine’s emergence is cleared by the age of 11-12, there’s a good chance it will emerge naturally. However, if the tooth remains impacted beyond the ages of 13-14, even if space is available, it’s unlikely to emerge on its own. In such cases, the tooth may become fused in place, making it immovable despite all efforts. The last resort in these situations is to remove the impacted tooth and consider alternative treatments like dental implants or fixed bridges. 

Expose and Bond Procedure  

In situations where the canine won’t emerge naturally, a collaborative effort between the orthodontist and oral surgeon is often necessary. Each case is unique, but commonly, the orthodontist will first place braces on the teeth, particularly on the upper arch, to create space for the impacted tooth. Once the space is prepared, the patient is referred to an oral surgeon to expose and bracket the impacted canine. 

 

During a simple surgical procedure, the oral surgeon lifts the gum to reveal the impacted tooth. If a baby tooth is still present, it’s usually removed at this time. An orthodontic bracket is then attached to the exposed tooth, along with a small gold chain. This chain is guided back to the orthodontic wire and temporarily attached. After the surgery, the patient returns to the orthodontist within 1-14 days to initiate the process of guiding the tooth into its proper position, which may take up to a year. 

What To Expect From This Surgery To Expose & Bracket An Impacted Tooth?

The procedure to expose and bracket an impacted tooth is straightforward and usually performed in the oral surgeon’s office, often under IV sedation. Post-surgery, minimal bleeding, and discomfort are to be expected, which can generally be managed with over-the-counter pain relievers like Tylenol or Advil. Swelling is minimal and can be alleviated with ice packs. A soft diet is recommended initially, but you can return to your regular diet as comfort allows. It’s best to avoid sharp foods that could irritate the surgical site. A follow-up with the orthodontist is usually scheduled within 1-14 days to begin the tooth’s guided emergence. If you have any questions or concerns, your surgeon is available for consultation. 

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