Exposure of Impacted Teeth
An impacted tooth simply means that it is “stuck” and cannot erupt into function. Patients frequently develop problems with impacted third molar or wisdom teeth. These teeth get “stuck” in the back of the jaw and can develop painful infections and other problems. Since there is rarely a functional need for wisdom teeth, they are usually extracted if they develop problems.
The maxillary cuspid (upper canine tooth) is the second most common tooth to become impacted. The cuspid tooth is a critical tooth in the dental arch and plays an important role in your “bite.” The cuspid teeth are very strong biting teeth that 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 tight together. If a cuspid tooth gets impacted, every effort is made to get it to erupt into its proper position in the dental arch. However, other teeth in the mouth can be impacted and require treatment.
Early recognition of impacted teeth is the key to successful treatment
The older the patient, the more likely an impacted tooth will not erupt by nature’s forces alone even if the space is available for the tooth to fit in the dental arch. The American Association of Orthodontists recommends that a panorex screening x-ray along with a dental examination be performed on all dental patients at around the age of seven years to count the teeth and determine if there are problems with eruption of the adult teeth.
It is important to determine whether all the adult teeth are present or are some adult teeth missing. Are there extra teeth present or unusual growths that are blocking the eruption of the tooth? Is there extreme crowding or too little space available causing an eruption problem with the tooth?
An exam is performed by your dentist or hygienist, who will refer you to an orthodontist if a problem is identified. Treating such a problem may involve an orthodontist placing braces to open spaces to allow for proper eruption of the adult teeth. Treatment may also require a referral to an oral surgeon for extraction of over retained baby teeth and/or selected adult teeth that are blocking the eruption of the impacted teeth. The oral surgeon will also need to remove any extra teeth (supernumerary teeth) or growths that are blocking eruption of any of the adult teeth.
If the eruption path is cleared and the space is opened up by a young age (11-12), there is a good chance the impacted tooth will erupt with nature’s help alone. If the tooth is allowed to develop too much (age 13-14), the impacted tooth will not erupt by itself even with the space cleared for its eruption. If the patient is older (over 40), there is a much higher chance the tooth will be fused in position. In these cases the tooth will not budge despite all the efforts of the orthodontist and oral surgeon to erupt it into place. Unfortunately, the only option at that point is to extract the impacted tooth and consider an alternate treatment to replace it in the dental arch (crown on a dental implant or a fixed bridge).