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What is Surgical Exposure for Orthodontics?

For many patients, permanent teeth will not erupt from the gums normally and will essentially be trapped completely, or partially, under the gums. While this is a common issue for wisdom teeth, canine teeth can also become impacted. Unlike wisdom teeth, though, canine teeth should never be removed as they are important for chewing and a proper bite. 

If your dentist or orthodontist notices that the canine teeth are not coming in properly by the age of 12 or 13, you may be referred to our office for a surgical exposure consultation. If the canine teeth have not come in properly, your orthodontist will be unable to move the teeth into proper position. It is important to surgically expose the impacted teeth so that your orthodontic treatment can be completed.


The Procedure

Prior to the procedure, the doctor will meet with you to discuss your options and to perform a complete examination. After the evaluation, your surgery will be planned. 

The actual procedure is completed in our office and with general anesthesia. Typically, the procedure will last between 45 and 90 minutes. During the procedure, the tooth will be surgically exposed and an orthodontic bracket and chain will be bonded to the tooth using a special cement. The chain is then attached to the orthodontic wires and stitches are placed in the gums if needed. 


How will the tooth come in after surgery?

After you have healed completely, your orthodontist will begin moving the tooth into position. The orthodontist will use the attached chain to gently “pull” the tooth down and into position. This process can take several months depending on the original position of the tooth. Rarely, the tooth may be ankylosed (fused to the bone) and may not come through the gum as planned. 


Early Detection is a Key to Successful Treatment

Teeth can become impacted for several reasons including:
  • The presence of extra teeth
  • Unusual growths that block the eruption of the tooth
  • Overcrowding due to extra teeth or misalignment of the front teeth
Prevention and early diagnosis includes the early screenings of patients by the age of 7. The American Association of Orthodontics recommends a full evaluation of all teeth through a Panorex x-ray to ensure that the teeth are developing correctly and to detect problems early. 

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