Erruption of the permanent dentition is a complicated event that for the most part goes smoothly in the the population at large. However occasionally canine(eye teeth) teeth, premolars and or other teeth can be locking into a position or path that will never lead to spontaneous erruption into the mouth. In these cases Dr. Gray is often called upon to find and expose these teeth for orthodontic purposes or to just remove the tooth if it is an extra or uneeded tooth. In the past this often required "exploratory surgery" to find the tooth which really meant more pain and discomfort but today this is no longer necessary with the advent of CT scanning. Dr. Gray has an I-CAT by Imaging Sciences that allows complete 3-D visualization of tooth and bony structures in your face that literally guides him to the exact site to minimize discomfort and improve your recovery.

Third molars (wisdom teeth) most commonly fall victim to impaction, but the upper canine is the second most common tooth to become impacted. Wisdom teeth serve no important function in the mouth and are frequently removed; however, impacted canines are critical to the bite and require treatment for the following reasons:

• Closing Gaps – Canines are the last of the front teeth to fall into place and therefore close any unsightly gaps between the other upper teeth.
• First Touch – Canines play a vital role in the “biting” mechanism of the teeth. They touch first when the jaw closes, and guide the other teeth into position.
• Proper Alignment & Function – Canine teeth are essential to the correct alignment and function of the other teeth on the dental arch. Missing or impacted canines can greatly affect the function and aesthetic appearance of the smile.

What causes canine teeth to become impacted?

There are several main causes for impacted canine teeth:

Extra Teeth – If extra teeth are present, the natural eruption of the canine teeth may be inhibited. The eruption progress of the canine may be directly blocked by an extra tooth or the subsequent overcrowding might leave no room on the dental arch for the canine.

Overcrowding – In some cases, poor alignment of the front teeth can lead to overcrowding. The existing teeth compete for space which means that the canines do not have sufficient room to become functional.

Unusual Growths – On rare occasions, unusual growths on the soft tissue of the gums can restrict the progress of canine teeth, which leads to later impaction.

Early and thorough examination of the teeth can pre-empt problems with impacted canines. It is important for the dentist to document the number teeth present when the patient is around 7 years of age in order to record the presence or absence of canine teeth. The older the patient becomes, the less likely it is that an impacted canine tooth will erupt naturally. 

Oral Examination

Dr. Gray conducts a thorough visual examination of the teeth, accompanied by an appropriate radiographic study. Once the cause of the impaction has been determined, there will be several treatment options available depending upon the age of the patient. The objective is to aid the eruption of the impacted canines, and this can be skillfully assisted by Dr. Gray and his staff. 

What does the treatment of impacted canines involve?

If your mouth is overcrowded for any reason, your dentist may recommend extraction of a tooth or teeth. Extraction of impacted teeth is generally performed under Intravenous Sedation by an Oral & Maxillofacial Surgeon like Dr. Gray. If the plan includes assisting the canine or other tooth to be put in the dental arch it likely will need an Expose and Bond Procedure.

Expose and Bonding: This is simply a procedure used to bring the tooth from underneath bone and gums into the mouth to be put in the right place with braces. It is accomplished again generally under Intravenous sedation where for gums are temporarily moved out of the way until the impacted tooth is found. Using bonding agent a gold chain with a special bracket is attached to the buried tooth. Gentle traction on the tooth by your Orthodontist will will help guide it to the correct location. This is a relatively painless operation that allows most patients to return to work/school the next day and often requires very little narcotic pain medication.