An impacted tooth means that it is stuck and can not erupt into function.

After the wisdom teeth, the maxillary cuspid is the most common tooth to become impacted. The cuspid tooth is critical in the dental arch and your bite. They are also designed to be the first teeth that touch when your jaws close together and guide the rest of the teeth into the proper bite. Normally, the maxillary cuspid teeth are the last of the front teeth to erupt, usually around age 13. However, if they don’t erupt, there are many techniques available to help aid eruption.

Impacted Tooth Removal

Treatment for helping proper eruption may sometimes involve the extraction of over retained baby teeth and/or select adult teeth that block the eruption of the cuspids. It may also be necessary to remove any extra teeth or growths that obstruct eruption of any of the adult teeth. If the patient is over the age of 40, there is a high chance that impacted tooth will be fused into its position. In this case, the tooth will not move despite efforts by oral surgeons to erupt it. At this point, the best option is to extract the impacted tooth and consider an alternate treatment to replace it, such as a fixed bridge or a crown on a dental implant.

Exposing and Bracketing Impacted Teeth

If the tooth doesn’t erupt automatically, the orthodontist and oral surgeon will work together to make it erupt. While each case is different, the most common scenario involves the orthodontist placing braces for a space to be opened in order to provide room for the impacted tooth to be moved into its correct position. Once the space is ready, the oral surgeon will then have the tooth exposed and bracketed.

The gum on top of the impacted tooth is lifted to expose the tooth underneath and an orthodontic bracket with a small chain is bonded to it. The surgeon will then guide the chain to the orthodontic arch wire and temporarily attach it there. Sometimes the tooth is left uncovered by suturing the gum high above the tooth. More often, the gum is returned to its previous location and sutured with just the chain remaining visible through a small hole in the gum. After surgery, a rubber band s attached to the chain putting a light pulling force on the impacted tooth, beginning the process of erupting the tooth. This is a slow process that may take up to a year to complete.

The surgery to expose and bracket an impacted tooth is a very straight forward procedure that can be performed in our office. Prior to surgery, you will have a consultation appointment where you will discuss your treatment plan with Dr. Hoffman and, as always, please call our office if you have any questions.