Exposure of Impacted Teeth

Whether your orthodontists placed orthodontic brackets or not, your orthodontist may request Dr. Silver to perform a simple surgical procedure where he lifts up the gum on top of the impacted tooth to expose the hidden tooth underneath. If there is a baby tooth present, Dr. Silver or Dr.Forrester will remove it at the same time. As a periodontist, Dr. Silver and Dr.Forrester work to save the preferred attached gum tissue around the tooth to eliminate the risk of requiring a soft tissue graft later. Even under the best circumstances, the eruption trajectory is not always predictable and you may need a soft tissue graft which is another procedure covered on this site.

Once he exposes the tooth, Dr. Silver or Dr.Forrester will bond an orthodontic bracket to the exposed tooth and depending on the method requested by the orthodontist, the bracket may have a miniature gold chain attached to it. If used, Dr. Silver or Dr.Forrester will guide the chain back to the orthodontic arch wire where he will temporarily attach it. Essentially, Dr. Silver or Dr.Forrester is making an alleyway which will allow the tooth to erupt into the mouth with less resistance. This alleyway may leave the exposed impacted tooth completely uncovered by suturing the gum up high above the tooth or making a window in the gum covering the tooth. Sometimes this window may end up on the palate or roof of the mouth, and sometimes Dr. Silver or Dr.Forrester can return the gum to its original location and suture it back with only the chain remaining visible as it exits a small hole in the gum.

Dr. Silver and Dr.Forrester encourage you to see your orthodontist within days to weeks after the uncovering as your orthodontist prefers. Once the orthodontist observes your progress, the tooth may still erupt on its own or the orthodontist may need to engage the bracket with the old chain or an arch-wire to help guide the tooth into place. Movement of the tooth into position may be rather quick or may take even a year. The objective is to try to save the tooth and not extract it.


Call us at Silver Periodontics & Implant Dentistry Phone Number 856-810-8400 if you have any questions or to schedule an appointment with Drs. Silver and Forrester today!