OMS Procedures

Impacted Canines

An impacted tooth simply means that it is “stuck” and cannot erupt into function. The maxillary canine teeth, also known as the upper cuspid or upper eyeteeth, are the second most common teeth to become impacted after the wisdom teeth. The cuspid teeth are “keystone” teeth in the dental arch and play an important role in your “bite”. The cuspid teeth are very strong teeth and 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.

 

The maxillary cuspid teeth usually erupt into place around age 13. If a cuspid tooth is impacted, every effort is made to aid its eruption into the dental arch. The technique 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. The majority of these impacted cuspids are located on the palate (roof of the mouth). The remaining impacted cuspids are found in the middle of the supporting bone stuck in an elevated position above the roots of the adjacent teeth or out to the facial side of the dental arch.

Early Recognition Of Impacted Eyeteeth Is The Key To Successful Treatment

The older the patient, the less likely an impacted cuspid will erupt even if the space is available for the tooth to fit in the dental arch. The American Association of Orthodontists recommends that a panorex screening x-ray, along with a dental examination, be performed on all dental patients around the age of seven years to count the teeth and determine if there will be problems with eruption of the adult teeth. Treatment may require referral to an oral surgeon for extraction of retained baby teeth and/or selected adult teeth that are blocking the eruption of the cuspids. The oral surgeon may also need to remove any supernumerary (extra) teeth or growths that may be blocking the eruption of any adult teeth. If the eruption path is cleared and the space is opened by the age of 11-12, there is a good chance the impacted cuspid will erupt unaided. If the cuspid is allowed to develop beyond age 13-14, it may not erupt by itself even with the space cleared for its eruption. In the adult patient, there is a much higher chance the tooth will be fused in position. At that age, the only option may be to extract the impacted tooth and consider an alternate treatment to replace it in the dental arch, such as placement of a dental implant or a fixed bridge.

What Happens If The Cuspid Will Not Erupt When Proper Space Is Available?

In cases where the cuspid will not erupt spontaneously, the orthodontist and oral surgeon work together to achieve the best results on an individual basis. The most common scenario will call for the orthodontist to place braces on the teeth to create a space to provide room for the impacted tooth to be moved into its proper position. Once the space is ready, the orthodontist will refer the patient to the oral surgeon to have the impacted cuspid exposed and bracketed. This is a simple procedure the gum over the impacted tooth is lifted to expose/uncover the hidden tooth underneath. Once the tooth is exposed, the oral surgeon will bond a bracket with a chain attached to it on the tooth. The chain will be used to guide the cuspid into the proper position.

 

The patient is first seen in our office for an evaluation. Dr. Angell will review the patient health history, evaluate the teeth presence and position on an x-ray, do an oral examination and discuss the uncover and bracketing procedure and types of anesthesia available. Patients will be offered either local anesthesia or, in addition, you may choose Nitrous Oxide and Oxygen sedation, also known as “laughing gas”. Dr. Angell will be able to answer any questions regarding the best anesthesia for your procedure.

 

Your evaluation appointment will take 20-30 minutes. Before leaving the office you will be given an estimate of the cost for your procedures and, if you would like, you will be able to schedule the surgical appointment with our technical staff. These surgical appointments are done in our office and last from 40-60 minutes.