What happens if the eyetooth will not erupt when proper space is available?

In cases where the eyeteeth will not erupt spontaneously, the orthodontist and oral surgeon will work together to get these teeth to erupt. Each case must be evaluated on an individual basis, but treatment will usually involve a combined effort between the orthodontist and the oral surgeon. The oral surgeon will expose and bracket the impacted eyetooth.nnThe goal is to erupt the impacted tooth and not to extract it. Once the tooth has moved into its final position, the gum around it will be evaluated. In some circumstances, there may be some minor “gum surgery” required.

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Exposure of Impacted Teeth

Q: What is an impacted tooth?

An impacted tooth simply means that it is “stuck” and cannot erupt into function. Patients frequently develop problems with impacted 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 (see Wisdom Teeth under Procedures). Since there is rarely a functional need for wisdom teeth, they are usually extracted if they develop problems. The maxillary cuspid (upper eyetooth) is the second most common tooth to become impacted. The cuspid tooth is a critical tooth and plays 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 so they guide the rest of the teeth into the proper bite.nnNormally, 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 tighter together. If a cuspid tooth gets impacted, every effort is made to get it to erupt into its proper position. The techniques involved to aid eruption can be applied to any impacted tooth in the upper or lower jaw, but most commonly they are applied to the maxillary cuspid (upper eye) teeth. Sixty percent of these impacted eyeteeth are located on the palatal (roof of the mouth) side of the dental arch. The remaining impacted eye teeth are found in the middle of the supporting bone, but are stuck in an elevated position above the roots of the adjacent teeth, or are out to the facial side of the dental arch.

If a permanent tooth is unable to erupt normally, it may require a minor oral surgery procedure to expose the tooth and help guide it into its proper position. At Summit Oral & Maxillofacial Surgery, our surgeons work closely with your orthodontist to expose impacted teeth and improve the chances of achieving a healthy, functional smile.

What Is an Impacted Tooth?

An impacted tooth is a tooth that becomes trapped beneath the gums or within the jawbone and cannot erupt into its normal position. While impacted wisdom teeth are the most common, the upper canine teeth (also called cuspids or eyeteeth) are the second most frequently impacted teeth.

Unlike wisdom teeth, canine teeth play an essential role in your bite. They help guide your teeth into proper alignment, support your facial appearance, and have the longest roots of any teeth in the mouth. Because of their importance, every effort is made to help impacted canines erupt rather than removing them.

Permanent upper canines typically erupt around age 11 to 13. When they fail to erupt, they may remain positioned:

On the roof of the mouth (palatal side)
Within the jawbone above neighboring tooth roots
Toward the lip or facial side of the dental arch

Approximately 60% of impacted canines are located on the palate, while the remaining cases occur within the bone or toward the facial side of the jaw.

Why Early Diagnosis Matters

Early diagnosis greatly increases the likelihood that an impacted canine can be successfully guided into its proper position. As patients get older, impacted teeth become less responsive to natural eruption and orthodontic treatment.

A comprehensive examination, panoramic X-rays, and sometimes 3D CBCT imaging allow your oral surgeon and orthodontist to determine:

Whether all permanent teeth are present
The exact position of the impacted tooth
Whether baby teeth or extra teeth are blocking eruption
The most appropriate treatment plan

In some cases, baby teeth, extra (supernumerary) teeth, or other obstructions must be removed before the impacted tooth can be successfully guided into place.

Success Rates Based on Age

The earlier treatment begins, the better the outcome tends to be.

Ages 11–12: Excellent chance of successful eruption once adequate space has been created.
Ages 13–14: The impacted canine is unlikely to erupt on its own, even after space has been opened, and surgical exposure is usually recommended.
Over age 40: There is a much greater chance the tooth has fused to the surrounding bone (ankylosis). In these cases, extraction followed by replacement with a dental implant or bridge is often the best option.

How Are Impacted Canine Teeth Treated?

If the tooth does not erupt naturally after orthodontic treatment has created enough space, your orthodontist and oral surgeon will work together to guide it into position.

During a surgical exposure procedure, the oral surgeon carefully uncovers the impacted tooth. In many cases, a small orthodontic bracket and chain are bonded to the tooth so your orthodontist can gradually move it into the proper position over time.

Whenever possible, preserving and positioning the natural tooth is preferred over extraction. After orthodontic treatment is complete, your surgeon will evaluate the surrounding gum tissue to determine whether any minor gum contouring is necessary for the healthiest long-term result.

Exposure and Bracketing of an Impacted Cuspid

Pulling the Cuspid Tooth Down with Braces

Successful Bite Correction for Canine Teeth

What to Expect During Exposure & Bracketing Surgery

Exposure and bonding of an impacted tooth is a routine outpatient procedure performed in our office. Most patients are comfortable with local anesthesia and nitrous oxide (laughing gas). For patients who prefer additional comfort, IV sedation may also be available.

If the procedure only requires exposing the tooth without placing an orthodontic bracket, the surgery is generally shorter and recovery is often quicker.

Before your procedure, your surgeon will review:

Your imaging and treatment plan
Anesthesia options
Recovery expectations
Postoperative care instructions

Most patients experience only mild discomfort and swelling for a few days and are able to return to normal activities shortly afterward.

Please review our Preoperative Instructions before your appointment. If you have questions about exposure of impacted teeth or your upcoming surgery, please contact Summit Oral & Maxillofacial Surgery.