An impacted tooth simply means that it is covered with bone and/or tissue and cannot erupt into proper function. The maxillary cuspid (upper eyetooth) is the second most common tooth to become impacted, second to impacted third molars, or wisdom teeth. The cuspid tooth is a critical tooth in the dental arch and plays an important role in your “bite”.
These teeth usually erupt into the mouth at around age 13. They are the last of the front teeth to erupt into place. If impacted they are usually located one the palatal (roof of the mouth) side. Sometimes, they are out to the facial side of the arch or stuck above the roots of the adjacent teeth.
The older the patient, the less the likelihood of bringing the impacted canine into position. These teeth can become ankylosed (fused to the bone). This is why it is so important that a dentist examine patients at an early age using panoramic x-rays to determine that all of the teeth are present and that they appear to be erupting properly. If your dentist identifies that there may be a problem, he or she will refer you to an orthodontist.
When this situation arises, Dr. Allard works together with your orthodontist. An orthodontist must first create space for the tooth using braces. If the baby tooth canine is still present, it is usually left into position until the arch is stabilized and ready for the canine to be uncovered.
Dr. Allard would then, remove the primary tooth and uncover the impacted canine. In this surgical procedure, the gum is lifted up and overlying bone is removed to expose the tooth. An orthodontic bracket with a gold chain attached to it, is bonded to the tooth. The gold chain is then temporarily attached to the orthodontic wire. This chain acts as a “leash” to guide the tooth slowly into position. The gum tissue is then sutured back to its original position.
Your orthodontist will then attach a rubber band to the chain to put light eruptive pulling forces on the impacted tooth. This process can sometimes take a while depending on the age of the patient and the distance that the tooth must be moved. Once the tooth has been relocated, the gum tissue around it will be evaluated. There are times that minor “gum surgery” is necessary to bulk up the tissue so that the tooth will remain healthy.
This procedure can be performed on any impacted tooth. Although, molars are much more difficult to move due to the fact that they have multiple, fully formed roots.
You can expect a small amount of bleeding from the surgical site after surgery. Minimal discomfort is usually associated with this procedure. Within two to three days after surgery there is usually little need for any medication at all. There may be some swelling from holding the lip up to visualize the surgical site: it can be minimized by applying ice packs to the lip for the afternoon after surgery. Bruising is not a common finding at all after these cases. A soft, bland diet is recommended at first, but you may resume your normal diet as soon as you feel comfortable chewing. It is advised that you stay avoid sharp food items like crackers and chips as they will irritate the surgical site if they jab the wound during initial healing. Dr. Allard will see you seven to ten days after surgery to evaluate the healing process and make sure you are maintaining good oral hygiene. You should plan on seeing your orthodontist soon after so that he can begin the process of moving the tooth. If you have any questions please call our office.