At The Center for Oral Surgery of Las Vegas, Dr. Carlos Letelier and our team takes pride in providing our patients with state-of-the-art oral procedures, including tooth exposure surgery! An unerupted tooth (impacted tooth) is a tooth that has formed underneath or outside of the gum line, but has not emerged on its own properly. Teeth that fail to properly erupt can damage surrounding teeth, gums, and supporting bones, leading to the formation of tumors and cysts that can severely disrupt the proper function of the jaw.
Teeth fail to erupt on their own for a variety of reasons, the most common being that the tooth eruption path is blocked by another tooth due to dental crowding. Alternatively, a baby tooth (whose roots would normally dissolve, allowing it to drop out) has not yet been lost, and is preventing the adult tooth from coming through.
Patients frequently develop problems with unerupted 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. The maxillary cuspid (upper eyetooth) is the second most common tooth to become unerupted. The cuspid tooth is a critical tooth in the dental arch, playing 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, guiding the rest of the teeth into a proper bite.
Here at The Center for Oral Surgery of Las Vegas, Dr. Letelier and our staff are highly experienced in unerupted tooth surgery, providing all of our patients with a relaxing environment and comfortable atmosphere. Before the tooth exposure procedure begins, our staff will recommended either a general anaesthetic where you will be asleep, or a local anaesthetic where you will be awake. In general, if the tooth is deeply buried, it is better to be asleep, as it may take some time to uncover it. If a tooth is quite shallow, tooth exposure surgery is a very quick and simple process, allowing the procedure to be performed under a local anaesthetic injection.
An unerupted tooth on the outside of the gums is uncovered by rolling the gum back and placing two stitches to hold it in position until the tooth erupts, bringing the gum along with it. If the tooth is on the inside, however, it is usually necessary to remove a small piece of gum – about the size of a little fingernail – to uncover the tooth. At the end of the operation, the area is covered with a surgical pack (a putty-like substance) that is held in place with a stitch until it hardens. Surgical pack acts to protect the area (much like a band aid), keeping the gum from growing back over the tooth.
Once the tooth is exposed, Dr. Letelier will bond an orthodontic bracket to the top of the tooth. This bracket will have a miniature gold chain attached to it, which will be guided to an orthodontic arch wire where it will be temporarily connected. Dr. Letelier will then choose to either leave the exposed impacted tooth completely uncovered by suturing the gum up high above the tooth, or by making a window in the gum covering the tooth. Most of the time, the gum will be returned to its original location and sutured back with only the chain remaining visible as it exits a small hole in the gum.
The length of time it takes to pull the tooth into position depends firstly on how deeply it is buried, and whether there are any other teeth in the way; and secondly, whether the space for the tooth has closed up and needs to be reopened with orthodontic braces. In most cases, the tooth can be moved into position within 9 to 12 months, but it may take a little longer to perfectly align all the other teeth in the area!