Exposure of Impacted Canine Teeth I West Midlands Hospital

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Uncovering (Exposure) of Impacted Canine Teeth for guided eruption for combined orthodontic treatment

Information about treatment for uncovering of impacted canines teeth. is. If you have any questions, you should ask your GP or Dentist.

Why uncovering (Exposure) of Impacted Canine Teeth for guided eruption for combined orthodontic treatment?

The upper or lower canines, normally erupts into the mouth between about the ages of 11 and 13. Sometimes teeth can develop in an abnormal position and the upper canine is the most common tooth to be affected in this way. Either one or both teeth may be affected. Often they will lie across the roof of the mouth behind the front teeth.

Sometimes lower canines are affected as well and may require similar treatment.

Why do I need treatment?

The upper canine has a long root making it a strong tooth and is an important tooth both for biting and in the development of a normal smile.

Sometimes they may be left alone and will remain un-erupted for many years, possibly a whole lifetime. They can, however, damage the roots of other front teeth or push them out of position. They can interfere with the orthodontic movement of other teeth. More rarely cysts can develop around them. Treatment is almost always provided as part of on-going orthodontic treatment to help the teeth to erupt normally into the mouth. A similar situation can happen with lower canines and could require treatment

What does the procedure involve?

Helping the tooth to erupt into the mouth involves a relatively minor surgical procedure. This may be carried out under local anaesthetic (injection in the gum) but often takes place under a “day case” under sedation or a general anaesthetic (put to sleep), going home the same day. Depending on the exact position of the un-erupted tooth; generally one, or a combination of three possible procedures, will be carried out:

1. If the tooth lies near the outside of the arch of teeth, ie near the lip, the gum can be moved up and re- positioned, being stitched in the new position exposing the crown of the tooth. Sometimes some thin soft bone will need to be removed from around the crown of the tooth.

2. If the tooth is in the roof of the mouth a small window of gum can be removed plus some bone if it is necessary from the palate. Usually an antiseptic pack is placed over the tooth, which is held in place by one or two stitches. This both protects the wound and helps to prevent the gum growing back over the tooth. It is usually left in the mouth for 2 weeks after which it is very simple to remove.

3. If the tooth is very deeply impacted then often the gum over it will be lifted up, the tooth exposed and a gold chain and bracket will be glued onto the crown. The gum is then put back and the chain is stitched to the outside of the gum where the orthodontist can use it to pull the tooth gradually into the correct position. Pulling can usually begin a couple of weeks after surgery when healing is complete.

What are the after effects?

Following surgery there is usually very little swelling but there will be some soreness. This is normally taken care of with simple painkillers such as paracetamol. It is not usually necessary to take antibiotics but your oral surgeon can indicate these if necessary. A review appointment is usually made 2 weeks following surgery, either with the surgeon or orthodontist.

What complications can happen?

  • Pain
  • Bleeding
  • Swelling
  • If a gold chain is used it can detach from the surface of the tooth and will need to be re-glued in
  • Occasionally canines will not erupt into position and may require extraction, this will be determine by your orthodontist who will be responsible for bringing the tooth into position

How soon will I recover?

You should be able to go home the same day. You should be able to go back to work the day after the procedure unless you are told otherwise but do not do any strenuous exercise for the first 24 hours. 

Normally after your procedure you are discharged back to your orthodontist who will continue with the treatment a few weeks after surgery. 

Summary

Uncovering of impacted canines teeth is a successful operation and part of a joint treatment for fixed braces (orthodontic treatment) to move the teeth into the correct position

Occasionally the the canine can be unsuccessful moved and the tooth is probably better removed.

Acknowledgements

Author: Mr Luis M Bruzual. Consultant Oral Surgeon

This document is intended for information purposes only and should not replace advice that your relevant health professional would give you.

 

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