An impacted tooth is any tooth that is prevented from reaching its normal position by the time it would have been expected. Teeth become impacted for a number of reasons; the most common is lack of space. Other reasons include but are not limited to; a tooth being in or facing the wrong direction, cysts, ankylosed (fused to the surrounding bone).
|Age – Upper Teeth||Age – Lower Teeth|
The most common teeth in the mouth to be impacted are the 3rd molars and are expected to erupt into the mouth of patients between the ages of 17 and 21. The next most common impacted tooth is the upper canine tooth. Canine teeth are often called ‘eye’ teeth; they are the teeth at the corner of our mouth and often have a pointed tip. Canine teeth are the most important teeth for a stable bite; they are designed to touch first and guide the other teeth into position. When a canine is missing it can affect the function and aesthetic appearance of a healthy smile.
The American Association of Orthodontists recommends that all dental patients at the age of seven have a thorough dental examination, including a panorex xray. This early examination helps determine if all adult teeth are present, if there are any extra teeth and if there are any potential issues regarding the eruption of the adult teeth. If a tooth is impacted due to overcrowding of the teeth, it may be decided that orthodontic treatment and/or the extraction of specifically selected teeth may help. However, if the tooth is misplaced or facing in the wrong direction for eruption, it would require a multidisciplinary approach with an Orthodontist and Oral Surgeon.
If your orthodontist or dentist refers you to our doctors regarding your impacted tooth, you will first be seen for a consultation appointment and if required a panorex X-ray will be taken; often we can utilize the X-ray supplied by your dentist or orthodontist. Occasionally, because of the position of the tooth it may be required for a CT Scan to be taken. If the impacted tooth needs surgical intervention an appointment will be made for the tooth to be exposed and for an orthodontic bracket to be bonded to the exposed tooth. After a follow up appointment you will be released back to your orthodontist who will use orthodontic treatment to gently move the tooth into its correct position in the dental arch.
Unfortunately, sometimes the impacted tooth is in a position that would not allow eruption to take place, even with orthodontic treatment. If this is the case a discussion will take place with yourself, the orthodontist, your dentist and one of our oral surgeons to decide the best course of treatment and when, or, if at all anything needs to be done.
Frequently Asked Questions
What anesthetic will be used?
After a thorough medical history is taken, our doctors will discuss with you the options we have available. We offer local anesthetic alone or along with; Nitrous Oxide (laughing gas), premedication or IV Sedation.
Why would I need a CT Scan?
CT Scan technology allows us to see a 3d image of your facial anatomy. This allows us to see exactly where your impacted tooth is lying, which helps us to determine how best to approach the tooth surgically.
Would there be additional cost for the CT Scan?
There is additional cost for the CT Scan; we can look at your medical insurance to see if it would be a covered benefit, often it would go toward your deductible.
What is involved in the surgery?
A flap of gum is removed, exposing the bone covering the impacted tooth. The bone is removed and the exposed tooth is cleaned thoroughly. Dental composite material is used to attach an orthodontic bracket to the tooth. The bracket may have a chain attached to it and the orthodontist would use this during the orthodontic treatment to move the tooth into the dental arch.
How long does it take for the tooth to come down once exposed?
The orthodontist will discuss this with you. Generally it depends on the position of the impacted tooth and patient’s compliance through treatment.
What happens if the tooth does not come down?
If the orthodontist decides that after a period of time the tooth is not moving, the patient may be referred back to one of our oral surgeons for further assessment. The tooth may be ankolysed to the bone surrounding it.
What does ankylosed mean?
A tooth that is ankylosed, means that the tooth root is fused with the surrounding bone. Around the root of a tooth are periodontal ligaments, these ligaments are attached to the root and the surrounding bone. When the tooth is ankylosed some or all of these ligaments are missing and the lining of the root, cementum, has boned with the bone.
Impacted canines can be uncomfortable if left untreated. If you want more information or to schedule a consultation with our doctors, call our office at (704) 291-7333.