Tooth Exposure


An impacted tooth simply means that it is “stuck” and cannot pass through your gums.  The maxillary cuspid (upper eye tooth) is the second most common tooth to become impacted.  It is a critical tooth in the dental arch and plays an important role in your “bite”.  The cuspid teeth are very strong biting teeth which 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 tight together. If a cuspid tooth gets impacted, every effort is made to get it to erupt into its proper position in the dental arch. The techniques involved to aid eruption can be applied to any impacted tooth in the upper or lower jaw, but most commonly they are applied to the maxillary cuspid (upper eye) teeth. 60% of these impacted eye teeth are located on the palatal (roof of the mouth) side of the dental arch. The remaining impacted canines are found in the middle of the supporting bone but stuck in an elevated position above the adjacent tooth roots.


In cases where the impacted teeth will not erupt spontaneously, your orthodontist and Dr. Serra 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 Dr. Serra.  The most common scenario will call for the orthodontist to place braces on the teeth (at least the upper arch).  A space will be opened to provide room for the impacted tooth to be moved into its proper position.  If the baby tooth has not fallen out already, it is usually left in place until the space for the adult tooth is ready.  Once the space is ready, the orthodontist will refer the patient to Dr. Serra to have the impacted tooth exposed and bracketed.


In a simple surgical procedure performed in our office, the gum on top of the impacted tooth will be lifted up to expose the hidden tooth underneath.  If there is a baby tooth present, it will be removed at the same time. Once the tooth is exposed, Dr. Serra may bond an orthodontic bracket to the exposed tooth.  The bracket will have a miniature gold chain attached to it.  Dr. Serra will guide the chain back to the orthodontic arch wire where it will be temporarily attached.


Shortly after surgery (1-14 days) the patient will return to the orthodontist.  A rubber band will be attached to the chain to put a light force on the impacted tooth.  This will begin the process of moving the tooth into its proper place in the dental arch.  This is a carefully controlled, slow process that may take up to a full year to complete.

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Tooth Exposure  |  Oral Pathology / Biopsy  |  Circumferential Fiberotomy  |  Conscious Sedation