Surgical assistance to help teeth
that don’t have enough room to erupt naturally
Early detection of teeth that are not coming in is very important. Your dentist or orthodontist may be trying to make space for teeth that have not yet erupted. With or without space, some teeth, particularly the canines or ‘eyeteeth’ may be impacted and not have enough room to erupt into the mouth without assistance. These teeth are an important component of a proper bite and they maintain proper function with chewing. Sometimes orthodontic treatment will be sufficient to provide enough room for the impacted tooth to move into its proper position. If the tooth fails to move into place on its own, you will need to have surgery to expose the tooth and aid its eruption.
Why is surgical exposure necessary?
When the eyeteeth are not able to erupt spontaneously surgery may be necessary. Dr. Tymkiw will work with your dentist and/or orthodontist to help get the eyeteeth to erupt. Each case will be evaluated on an individual basis however you can expect to have a consultation and xrays to determine which teeth are affected and to evaluate the adjacent structure such as tooth roots, nerves, and the sinuses.
During the surgical procedure Dr. Tymkiw will lift up the gum on top of the impacted tooth to expose the hidden tooth underneath. If there is a baby tooth present, Dr. Tymkiw will remove it at the same time. As a periodontist, Dr. Tymkiw works to save the preferred attached gum tissue around the tooth to eliminate the risk of requiring a soft tissue graft later.
What to expect with the surgery
The surgery is performed in the office and under sedation. The surgery can take between 45 and 90 minutes, depending on the difficulty. At the time of surgery, the tooth is completely surgically exposed, and, in conjunction with your orthodontist, an orthodontic bracket and attached chain is often bonded to the tooth with a special cement. If used, Dr. Tymkiw will guide the chain back to the orthodontic arch wire where he will temporarily attach it. Essentially, Dr. Tymkiw is making an alleyway which will allow the tooth to erupt into the mouth with less resistance.
Typically you will will see your orthodontist shortly after the surgical eruption procedure. Your orthodontist will use the attached chain to gently “pull” the tooth into position. This can take several months, depending on the tooth’s original position. This is a carefully controlled, slow process that may take up to a full year to complete. Remember, the goal is to erupt the impacted tooth and not to extract it! Once the tooth is moved into the arch in its final position, the gum around it will be evaluated to make sure it is sufficiently strong and healthy to last for a lifetime of chewing and tooth brushing. In some circumstances, especially those where the tooth had to be moved a long distance, there may be some minor “gum surgery” required to add bulk to the gum tissue over the relocated tooth so it remains healthy during normal function.
Refer to Post Surgical Instructions for aftercare recommendations.