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In children, unerupted teeth that become impacted usually require surgical exposure to help them erupt. While the upper canines are the second most common teeth to become impacted after wisdom teeth, incisor teeth and premolar teeth can also become impacted.
The canine teeth are critical teeth in the dental arch and they play an important role in your “bite” or occlusion, and they are also important for appearance. They are designed to be the first teeth that meet when your jaws close together so they guide the remaining teeth into the proper bite. For this reason, orthodontists work with oral surgeons to get impacted canines to erupt.
Each case is evaluated on an individual basis, but treatment usually involves a team effort between the orthodontist and oral surgeon. The surgical options include:
The orthodontist usually places braces on the teeth first and a space is opened to provide room for the impacted canine tooth to be moved into the proper position. The orthodontist will then refer the patient to the oral surgeon to have the impacted canine tooth exposed.
The exposure of the tooth involves an operation where some gum tissue and bone overlying the tooth is removed, resulting in the crown of the tooth being exposed. Depending on the individual case, the oral surgeon might place a dressing over the tooth, which is held with stitches that are removed after 10 – 14 days. This allows the orthodontist to begin treatment for repositioning the tooth. Alternatively, the oral surgeon will bond an orthodontic bracket and gold chain onto the exposed tooth and the patient will return to the orthodontist to have the tooth repositioned into its proper place in the dental arch. The orthodontic repositioning process is a slow and carefully controlled manoeuvre that may take up to 1 year to complete.