Teeth are “impacted” if they fail to erupt and pass through the gums. The most common teeth to be impacted are the third molars, commonly known as wisdom teeth. After the wisdom teeth, the maxillary cuspid is the second most common tooth to become impacted.
Located between the incisors and first premolar, cuspid teeth are easily recognized by their distinctively pointed shape and are often called Canine teeth. These teeth have the longest roots of any human teeth, causing them to be very strong biting teeth. They play an important role in the dental arch because they are the first teeth that touch when your jaws close together, guiding the rest of the teeth into the proper biting position. For most people, the maxillary cuspids are the last of the front teeth to erupt into place. This typically happens between the ages of 11 and 13.
There are several reasons that a tooth can become impacted and fail to fully erupt. The most common causes of tooth impaction are insufficient space in the jaw and the overcrowding, misalignment, or conflicting position of teeth in the jaw.
If canine teeth can’t find room to grow in an overcrowded mouth, they may become partially emerged or completely trapped under the gums. Like impacted wisdom teeth, impacted canines can lead to many problems. Potential problems caused by impacted canine teeth include:
Early evaluation and treatment of impacted canine teeth is the best way to resolve and prevent the problems associated with them.
Early detection is a key element in the success of impaction treatment. When the eruption path for the impacted canine tooth is cleared by age 11 or 12, it is likely that the impacted canine will erupt on its own. If the impacted canine tooth and its roots are allowed to develop due to delayed detection, treatment will probably require surgery. The further the patient is into adulthood, the higher the chance the impacted tooth will be fused to the surrounding bone. Once total fusion has occurred, the only treatment option is to extract the impacted canine tooth and insert a dental implant in its place.
The treatment of impacted canine teeth differs from the treatment of impacted wisdom teeth because the goal is eruption, not extraction. Since the most common cause of impacted canine teeth is overcrowding in the jaw, the first step in their treatment is to create a space for them to grow. Orthodontists often attempt to do this by placing braces on the upper teeth to open spaces for the eruption of the impacted canines. For many people, treatment of impacted canines requires the extraction of baby teeth and/or adult teeth that are blocking the eruption of the cuspid tooth to be performed by an oral and maxillofacial surgeon.
If the impacted canine tooth fails to erupt spontaneously after an orthodontist has applied braces to the upper teeth and created an opening for its growth, Dr. Lombardo will perform a simple surgical procedure to expose and bracket the impacted canine tooth. During this procedure, the gum is lifted to expose the impacted tooth. Your oral surgeon will place an orthodontic bracket with a small gold chain attached to it on the exposed tooth. This chain links the bracket to the orthodontic wire. Once the sutures heal, the patient can return to their orthodontist. A rubber band will be attached to the chain and used to pull the impacted canine tooth into its proper location. A CT scan is often used to locate the impacted tooth, identify adjacent teeth, and determine the best surgical approach.
If detected at an early age, a patient may have surgery to expose impacted canine teeth before braces are even applied. Exposing an impacted canine tooth at an early age will promote some eruption to occur before the tooth becomes completely impacted.
In most cases, impacted canine teeth can be exposed and bracketed safely and easily in our facility using either nitrous oxide or IV sedation. Surgery to expose and bracket an impacted tooth is generally scheduled for 30 minutes if one tooth is being exposed and bracketed. It takes about 60 minutes if both sides require treatment. A preoperative examination will be conducted before your procedure to answer any questions you have regarding your specific case.
As with any surgical procedure, your specific recovery will depend on many factors. Most patients will experience mild discomfort and bleeding after surgery and will be limited to a soft diet until the discomfort passes. Dr. Lombardo may prescribe antibiotics or pain medications if necessary, but many patients find Tylenol or Advil to be adequate management for any pain they experience. Dr. Lombardo will discuss the details of your surgery and recovery with you before your procedure.
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A Note to our Patients about Coronavirus COVID-19
Our patient’s health, and the health of our team is of the utmost importance and we encourage everyone to remain vigilant. As we continue to actively monitor developments related to coronavirus (COVID-19) we want to assure you that we are taking all necessary health and safety precautions in accordance with the Centers for Disease Control and Prevention (CDC) and local and state health officials.
Under the advisement of the American Dental Association, the North Carolina Dental Board and federal and local government officials, our practice will close effective 3/20/2020 and all appointments will be automatically cancelled until further notice. A member of our staff will call to reschedule your appointment once we return to the office. We will be available on an emergency basis to assist our patients if needed. We appreciate your trust in our practice and look forward to treating our patients as soon as it is safe to resume normal operations.
We hope everyone remains safe as we navigate through this challenging time together.
Dr. Gregg Lombardo
And the team at Gregg A. Lombardo, DDS.