SURGICAL EXPOSURE OF IMPACTED TEETH WITH OR WITHOUT PLACEMENT OF BONDED ON BRACKET

  1. WHAT IS AN IMPACTED TOOTH? All teeth are formed deep within the jawbones. They usually erupt into the mouth. When a tooth is blocked from reaching its normal position by another tooth or bone, it is called an impacted tooth.
  2. WHY SHOULD IMPACTED TEETH BE UNCOVERED? If not uncovered to permit eruption or removed, most impacted teeth will eventually cause a problem. The most common problem is infection of the gum tissues around the tooth (pericoronitis). This infection is always painful and can potentially spread throughout the head and neck. Other common problems associated with impacted teeth include decay of the tooth under the gum, damage to the roots of adjacent teeth, and formation of cysts. Pain, infection and destruction of bone in the area can be the result. In addition, some impacted teeth are important to the function and the appearance of your bite. Your orthodontist and/or dentist have determined that the involved impacted tooth is important to the overall scheme of your occlusion (bite). For this reason they have referred you for possible surgical uncovering and placement of a bonded on bracket.
  3. HOW ARE IMPACTED TEETH UNCOVERED? The procedure for uncovering these teeth requires an incision in the gum, exposing and removing a portion of the bone that is blocking the tooth from coming in. If indicated, the tooth crown will be etched with acid and a bonded on bracket will be adapted. This bracket has a chain attached to it that will be used by your orthodontist with elastic traction to pull the tooth into its proper position.
  4. CAN THE PATIENT EAT PRIOR TO SURGERY? If a general anesthetic or intravenous (IV) sedation is planned, there should be no food or liquids taken for eight hours prior to the procedure (to do so could result in severe bodily harm). However, you should take your routine daily medicine prescribed by your doctor with a sip of water (Exception: blood thinners and insulin replacement).
  5. WHAT ARE THE ANESTHESIA RISKS? They may include nausea, inflammation of the veins (less than 5%), and allergic reactions [a rash, swelling, or even a medical emergency may occur, but that's extremely rare (less than .01%)].
  6. WHAT ARE THE MOST COMMON PROBLEMS AFTER SURGERY?
    1. DISCOMFORT: May require prescription pain medications. Persistent soreness is often present for several days.
    2. SWELLING: Usually worse on one side than the other. Takes about 2-3 days to reach its peak. Then, subsides over the next week.
    3. DECREASED MOUTH OPENING: The jaw muscles often become stiff and limit the amount of mouth opening for several days. Rarely, the joint itself is affected. Mention it to your surgeon if it is persistent.
    4. BLEEDING: Some mild oozing is normal for up to 24 hours. There may be slight bleeding from the area when you brush your teeth for the first week.
    5. INFECTION: Infections are rare during the first few days after surgery. If an infection does occur, it is more likely 4 to 8 weeks after surgery. Treatment is usually uncomplicated, but you should see your surgeon.
    6. NUMBNESS: Impacted teeth may be in close proximity to the nerves that supply sensation to the teeth, gums, tongue, cheeks, chin and lips. Occasionally these nerves are injured when the tooth is exposed, causing numbness and tingling. If this happens, the nerve usually repairs itself. In some cases, numbness is permanent.
    7. SINUS INJURY: Because upper (back) posterior teeth are near the sinus cavity, the exposure of these teeth may cause an opening (hole) in the sinus cavity. The sinus usually heals, but further treatment may be necessary.
    8. ANKYLOSIS: If the impacted tooth is fused (ankylosed) to the surrounding bone, then failure to erupt may be possible. If this happens, the tooth will usually require removal.
    9. LOSS OF BRACKET: If this occurs, you will need to return to our office for replacement.


Pre-Op


Bonded on Bracket in Place


Closure


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