These basic principals can be adapted to apply to any impacted tooth in the mouth. It is not that uncommon for both of the maxillary cuspids to be impacted. In these cases, the space in the dental arch will be prepared on both sides at once. When the orthodontist is ready, Dr. Scott will expose and bracket both teeth in the same visit so that the patient only has to heal from one surgery. Because the anterior teeth (incisors and cuspids) and the bicuspid teeth are small and have single roots they are easier to erupt if they get impacted than the posterior molar teeth. The molar teeth are much bigger teeth and have multiple roots making them more difficult to move. The orthodontic maneuvers needed to manipulate an impacted molar tooth can be more complicated because of their location in the back of the dental arch.
Recent studies have revealed that with early identification of impacted eyeteeth (or any other impacted tooth other than the wisdom teeth), treatment should be initiated at a younger age. Once the general dentist or hygienist identifies a potential eruption problem, the patient should be referred to the orthodontist for early evaluation. In some cases the patient will be sent to Dr. Scott before braces are even applied to the teeth. As mentioned earlier, Dr. Scott will be asked to remove over-retained baby teeth and/or selected adult teeth. She will also remove any extra teeth or growths that are blocking the eruption of the developing adult teeth. Finally, she may be asked to simply expose an impacted eyetooth without attaching a bracket and chain to it. In reality, this is an easier surgical procedure to perform than having to expose and bracket the impacted tooth. This will encourage some eruption to occur before the tooth becomes totally impacted (stuck). By the time the patient is at the proper age for the orthodontist to apply braces to the dental arch, the eyetooth will have erupted enough so that the orthodontist can bond a bracket to it and move it into place without needing to force its eruption. This saves time for the patient and means less time in braces (always a plus for any patient)!
What To Expect From Surgery To Expose & Bracket An Impacted Tooth
The surgery to expose and bracket an impacted tooth is a very straightforward surgical procedure that is performed in Dr. Scott‘s office. For most patients, it is performed using laughing gas and local anesthesia. In selected cases, it will be performed under IV sedation if the patient desires to be asleep, but this is generally not necessary for this procedure. The procedure is scheduled for approximately 30 minutes if one tooth is being exposed and bracketed, and 45 minutes if both sides require treatment. If the procedure only requires exposing the tooth with no bracketing, the time required will be shortened by about one half. These issues will be discussed in detail at your preoperative consultation with Dr. Scott. (You can also refer to Preoperative Instructions under Surgical Instructions on this website for a review of any details).
You can expect a limited amount of bleeding from the surgical sites after surgery. Although there will be some discomfort after surgery at the surgical sites, most patients find Tylenol or Advil to be more than adequate to manage any pain they may have. Within two to three days after surgery, there is usually little need for any medication at all. There may be some swelling from holding the lip up to visualize the surgical site; it can be minimized by applying ice packs to the lip during the afternoon after surgery. A soft, bland diet is recommended at first, but you may resume your normal diet as soon as you feel comfortable chewing. It is advised that you avoid sharp food items, like crackers and chips, as they will irritate the surgical site if they jab the wound during initial healing. Dr. Scott will see you seven to ten days after surgery to evaluate the healing process, remove any sutures and make sure you are maintaining good oral hygiene. You should plan to see your orthodontist within 1-14 days to activate the eruption process (applying the proper rubber band to the chain on your tooth). As always, Dr. Scott is available at the office and can be contacted after hours if any problems should arise after surgery. Simply call Port Charlotte Office Phone Number 941-625-8500 at if you have any questions.