Patients frequently develop problems from impacted third molars (wisdom teeth). The maxillary canines (cuspid) is the second most common tooth to become impacted and they are a critical tooth in the dental arch that holds facial form as well the occlusion. They usually come into place around 13 years old and properly space the upper front teeth. If a canine becomes impacted every effort is made to erupt the tooth into proper position within the dental arch. Early treatment is the key to success in erupting these teeth. The older the patient the more likely that it will not erupt on its own even if there is space within the dental arch. The American Association of Orthodontics recommends that a panorex x-ray along with a dental exam be performed by the age of 7 years old. If the canine is allowed to form its root (age 13-14) in an impacted position it becomes more difficult to bring it into proper erupted position.
What Happens If The Eyetooth Will Not Erupt When Proper Space Is Available?
The most common treatment sequence is for the orthodontist to place braces on the teeth, open room for the impacted canine and the oral surgeon exposes just the crown of the impacted canine. A small bracket is placed on the crown, the gum is closed and a gold chain is attached to the braces. An elastic is placed onto the chain. Using the orthodontic braces the tooth is slowly brought into position over 6-12 months. The bone and gum erupts and forms as the tooth comes into place. This technique has a very high degree of success and causes the patient minimal discomfort.
Exposure and Bracketing of an Impacted Cuspid
Commonly the wisdom tooth is sitting behind or on top of the impacted second molar. Years ago the treatment for this was either extraction of the second molars or removal of the third molars and elevation of the second molars into place at the time of wisdom tooth removal. This often resulted in loss of the second molar later in life. Today we use a special orthodontic wire with another type of bracketing to slowly erupt the second molar into normal anatomic position. As with the impacted canines this is also quite successful and results in healthy bone and gums. This also requires orthodontic braces to leverage the second molar against the bracing wire. The wisdom teeth must be removed at the time of second molar exposure. This uprighting usually takes 6 months to a year.