Exposure of Impacted Teeth New Philadelphia

What is an impacted tooth?

An impacted tooth simply means that it is “stuck” and cannot erupt into function. Patients frequently develop problems with impacted third molar (wisdom) teeth. These teeth get “stuck” in the back of the jaw and can develop painful infections, among a host of other problems (see Wisdom Teeth under Procedures). Since there is rarely a functional need for wisdom teeth, they are usually extracted if they develop problems. The maxillary cuspid (upper eyetooth) is the second most common tooth to become impacted. The cuspid tooth is a critical tooth and plays an important role in your “bite”. The cuspid teeth are very strong biting teeth 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 cuspid teeth are the last of the “front” teeth to erupt into place. They usually come into place around age 13 and cause any space left between the upper front teeth to close tighter together. If a cuspid tooth gets impacted, every effort is made to get it to erupt into its proper position. The techniques involved to aid eruption can be applied to any impacted tooth in the upper or lower jaw, but most commonly they are applied to the maxillary cuspid (upper eye) teeth. Sixty percent of these impacted eyeteeth are located on the palatal (roof of the mouth) side of the dental arch. The remaining impacted eye teeth are found in the middle of the supporting bone, but are stuck in an elevated position above the roots of the adjacent teeth, or are out to the facial side of the dental arch.

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Early Recognition of Impacted Eyeteeth Is the Key to Successful Treatment

The older the patient the more likely an impacted eyetooth 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, along with a 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 surgeon for extraction of over-retained baby teeth and/or selected adult teeth that are blocking the eruption of the all-important eyeteeth. The oral surgeon will also need to remove any extra teeth (supernumerary teeth) or growths that are blocking the eruption of any adult teeth.

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

In cases where the eyeteeth will not erupt spontaneously, the orthodontist and oral surgeon will work together to get these teeth to erupt. Each case must be evaluated on an individual basis, but treatment will usually involve a combined effort between the orthodontist and the oral surgeon. The oral surgeon will expose and bracket the impacted eyetooth.


Exposure and Bracketing of an Impacted Cuspid


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 the oral surgeon’s office. This procedure is routinely performed with IV sedation. If the procedure only requires exposing the tooth with no bracketing, the time required will be shortened. These issues will be discussed in detail at your preoperative consultation with your doctor.

Refer to Preoperative Instructions under Surgical Instructions on this website for a review of any details. Simply call Tuscarawas Oral Surgery And Implant Center at Tuscarawas Oral Surgery And Implant Center Phone Number 330-364-8665 if you have any questions.

After Exposure of an Impacted Tooth

Bleeding – It is normal to have some bleeding  for 24 hours after your procedures. Excessive bleeding can be controlled by biting firmly against the gauze for 30-45 minutes so pressure is continuously applied to the surgery site. Replace gauze every 30-45 minutes if bleeding persists. Do not spit. If you spit continuously, you may experience prolonged bleeding.  If gauze is not heavily saturated with blood, you may stop using the gauze.

Swelling – The swelling that is normally expected is usually proportional to the surgery involved. This is the body’s normal reaction to surgery and eventually repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. It is expected for swelling to persist for approximately one week after surgery. Everyone has a different post-operatives experience. However, swelling should increase or be stable for the first 1-3 days after surgery and the swelling should show gradual improvement after day 4.

Pain – Take the prescribed pain medications as soon as possible. Try to take your pain medications before the local anesthetic has diminished. The prescribed medications should be taken as directed. Do not take any of the medication if you are allergic to them, or have been instructed by your doctor not to take it. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. Pain should show gradual improvement after day 4.

Antibiotics – If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash, upset bowels or any other unfavorable reaction and contact our office immediately. Call our office at Tuscarawas Oral Surgery And Implant Center Phone Number 330-364-8665 if you have any questions.

Diet – Soft food and liquids should be eaten on the day of surgery. Reestablishing your normal diet after oral surgery is beneficial to promote healing and drink plenty of fluids. Avoid hot liquids or hot food.  Gradually resume back to a normal diet is highly encouraged. You may eat what is tolerable for you and you will feel a lot better. A high calorie, high protein intake is very important. Nourishment should be taken regularly.

Oral Hygiene – It is extremely important to maintain a good oral hygiene. Clean your mouth thoroughly after each meal, beginning the day after surgery. Brush your teeth normally if possible. Rinse your mouth several times a day with a prescribed mouth rinse/ salt water/ plain water especially after meals and before bed. Brush and floss normally. Be gentle around surgical sites but keep the areas clean. Be sure to rinse for at least 30 seconds then gently spit it out. A clean wound heals better and faster.

REMEMBER: A clean wound heals better and faster.

Activity – Keep physical activities to a minimum immediately following surgery. If you exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Be aware that your normal nourishment intake may be reduced. Exercise may weaken you. If you get light headed, stop exercising.

Nausea & Vomiting – In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour, including the prescribed medicine. You should then sip on coke, tea, or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine. You may eat what is tolerable for you. You will feel better and have more strength if you start eating normally.

Sutures – Sutures may be placed during your surgery IF they promote healing. The sutures placed in our office are resorbable (they will naturally be removed) and do not require removal in our office. Sometimes sutures become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it.