What is an impacted tooth?

An impacted tooth is “stuck” and cannot erupt into function. Patients frequently develop problems with impacted third molar (wisdom) teeth. These teeth get “stuck” at the back of the jaw and can develop painful infections, as well as other problems. Since there is rarely a functional need for wisdom teeth, they are usually extracted if they become symptomatic. The maxillary canine is the second most common tooth to become impacted. The canine is a critical tooth in the dental arch that plays an important role in your bite, tooth alignment, and facial form. These teeth are very strong 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.

Normally, the maxillary canines are the last of the “front” teeth to erupt into place. They usually come into position around the age 13 and cause any space left between the upper front teeth to close tighter together. If the canine gets impacted, every effort is made to get it to erupt into its proper position. Sixty percent of these teeth are located on the palatal (roof of the mouth) aspect of the dental arch. The other 40% are found in the middle of the supporting bone, but remain in an elevated position above the roots of the adjacent teeth, or positioned on the outer aspect of the dental arch.

Early Recognition of Impacted Canines Is the Key to Successful Treatment

The older the patient, the more likely an impacted canine will not erupt by natural forces alone, even if the space is available for the tooth to fit in the dental arch. A panoramic x-ray, possible 3D imaging, and a thorough dental examination, will help determine whether all the adult teeth are present or if some adult teeth are missing.

Treatment may require referral to an Oral and Maxillofacial Surgeon for the extraction of retained baby teeth and/or selected adult teeth that are blocking the eruption of the canines. Dr. Pierse may also need to remove any extra teeth (supernumerary teeth) or growths that are blocking the path of eruption.

Impacted tooth success by patient’s age:

  • 11-12 years old – with space opened for eruption, good chance for success.
  • 13-14 years old – the impacted canine will not erupt by itself, even with the space cleared for its eruption.
  • Over 40 years old – much higher chance that the tooth will be fused (ankylosed) into position. The only option is to extract the impacted tooth and replace it with a dental implant restoration or fixed bridge.

What happens if the canine will not erupt when proper space is available?

In cases where the canine will not erupt spontaneously, the Orthodontist and Oral and Maxillofacial Surgeon will work together to get these teeth to erupt. Each case must be evaluated on an individual basis, but collaborative treatment will provide the best possible outcome. Dr. Pierse will expose and bracket the impacted canine allowing the Orthodontist to bring the tooth into the patient’s dental arch. The goal is to erupt the impacted tooth and not to extract it.

What to expect from surgery to expose and bracket an impacted tooth

The surgery to expose and bracket an impacted tooth is a routine procedure that is performed at Precision Oral and Maxillofacial Surgery. For most patients, the surgery can be completed under local anesthesia. In select cases, IV sedation may be utilized to complete the procedure while the patient is asleep. Risks, benefits, and treatment alternatives will be discussed in detail at your initial consultation with Dr. Pierse.

If you would like a consultation, please contact Precision Oral and Maxillofacial Surgery online or by phone at (623) 518-2325.