Exposure of Impacted Teeth
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.
Normally, 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.
Early Recognition of Impacted Eyeteeth Is the Key to Successful Treatment
The older the patient the more likely an impacted eyetooth will not erupt by natural forces alone, even if the space is available for the tooth to fit in the dental arch. A panoramic x-ray, along with a dental examination, will help determine whether all the adult teeth are present or if some adult teeth are missing.
Treatment may require referral to an oral surgeon for extraction of over-retained baby teeth and/or selected adult teeth that are blocking the eruption of the all-important eyeteeth. The oral surgeon will also need to remove any extra teeth (supernumerary teeth) or growths that are blocking the eruption of any adult teeth.
Impacted tooth success by patient’s age:
- 11-12 years old – with space opened for eruption, good chance for success.
- 13-14 years old – the impacted eyetooth will not erupt by itself, even with the space cleared for its eruption.
- Over 40 years old – much higher chance that the tooth will be fused in position. The only option is to extract the impacted tooth and replace it with a crown on a dental implant or a fixed bridge.
- These are general guidelines and provide the thoughts of the younger the patient the higher the success rate will likely be. As we age the likelihood of successful orthodontic traction of these canine teeth into the correct occlusion does decrease.
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 allowing the orthodontist the ability to place traction of the impacted tooth attempting to establish the tooth in occlusion.
The 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.
Exposure and Bracketing of an Impacted Cuspid












What to expect from surgery to expose & bracket an impacted tooth
The surgery to expose and bracket an impacted tooth is a very straightforward surgical procedure that is performed in the oral surgeon’s office. For most patients, it is performed using laughing gas and local anesthesia. In selected cases it will be performed under IV sedation if the patient desires to be asleep, but this is generally not necessary for this procedure. If the procedure only requires exposing the tooth with no bracketing, the time required will be shortened by about one half. These issues will be discussed in detail at your preoperative consultation with your doctor.
Refer to Preoperative Instructions under Surgical Instructions on this website for a review of any details. Simply call Oral Surgery Associates at Grand Rapids Phone Number 616-942-2000 if you have any questions.
Oral Surgery Associates
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Very friendly staff. I had Dr. Bezak and he was very personable and kind. He did a fantastic job with the surgery. I would recommend OSA to anyone.
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Confident, that is how I feel about this procedure. Prepping for an implant, and I am sure that will be a breeze. I hope to not need OSA again, but if I do, I will be confident that I will be taken care of.
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Dr. Kintz is amazing! My daughter first saw him 10yrs ago for 2 extractions at the age of 6yr. old. Last week she had all 4 impacted wisdom teeth removed. He has the best bed side manner and is so friendly. He put us both at ease and did a wonderful job. She was in quite a bit of pain the next day due to the depth of her top wisdom teeth, and who called me back after leaving a message with the emergency staff...... none other than Dr. Kintz himself. He goes above and beyond and you feel it from the first meeting. He is exceptional!!!!
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My father was the patient and was referred over to Dr.Kintz. I just wanted to let everyone at your office know what a great environment you have and how friendly everyone was. I also work in healthcare and unfortunately people hear more about the bad than the good. Huge thank you to everyone and especially Dr.Kintz for squeezing my father in to have the actual extractions done today.
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Dr. Kintz is the best! Very gentle, very patient, and super kind. I have had extractions and implants. I wouldn’t go to any other doctor.
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Thank you to all of the staff at Oral Surgery Associates, you are all very informative, by answering any and all questions. You are understanding to the patient and their concerns and that life happens. I thank you all very much for everything. I will highly recommend you to anyone!
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DR. KINTZ IS THE GREATEST. HE IS SO GENTLE AND HAS GREAT BESIDE MANNER.
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My appointment was for a dental extraction, which was my initial preference versus undergoing root canal and crown procedures. But unbeknownst to me, the extraction was a high risk proposition due to my currently rather complex health condition. Yet, without objection or elaboration, two general dentists I had earlier consulted had independently asserted that the extraction was understandable and presently doable, but definitely should be performed by an oral surgeon. In later preparation for the extraction, however, Dr.Kintz immediately recognized certain risks associated with the extraction at this particular time, and after promptly conversing with the second dentist I had consulted, strongly advocated having a dental specialist (endodontist) perform an immediate root canal procedure as the best present action to be taken. He explained that doing the extraction now could possibly result in significant consequences that ought to be avoided if at all possible. I greatly appreciated Dr. Kintz's unhesitating professional and ethical assessment of this situation and the advice rendered in reversing my initial intentions. His recommendations were unequivocally endorsed and successfully performed the same day by a highly regarded dental specialist to whom I was referred.
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I was very impressed with the new office, since I have had appointments at the previous location in the past. The new building is so clean & modern! I love the décor and all the modern updates....it's very high tech. I have also been extremely happy with the care I have received from Dr. Dingman and his staff. The procedures relating to my extraction and implant were a bit anxiety inducing but I quickly found that there was no need to be anxious. Dr. Dingman made me feel very comfortable and I had little to no pain & no complications. My follow up appointments have been thorough, but at the same time, quick & easy. I appreciate all the staff at Oral Surgery Associates for all their help & care during my implant process & I love, love, LOVE the new office!
- Carrie W
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I was super impressed with the new office! So light & airy. The new building is so clean & modern!. I love that the reception area is very open now and there's no longer separation from the reception staff with the "government building type" glass window. The staff is very polite and I have always felt comfortable & well taken care of by the doctors & nurses. Having a tooth extracted and going through the implant process can be stressful. It was definitely made easier with the capable & polite staff and the great NEW facility.
- Carrie W