Some teeth remain within the bone or gums even though it is time for them to erupt. This is most often seen in the upper canines and is usually noticed on a routine radiograph. Orthodontics for impacted teeth aims to bring these teeth into the arch with planned forces instead of extracting them. As DijiDent Oral and Dental Health Polyclinic, in Türkiye our priority in these cases is to preserve the tooth in its own place.
Why Does It Remain Impacted?
- Lack of space: There is no area left where the tooth can erupt.
- Deviation of the eruption path: The tooth moves in the wrong direction.
- Late loss of the baby tooth: The path of the permanent tooth remains blocked.
- Presence of an extra tooth: There is an additional tooth that prevents eruption.
- Cysts or other formations: They can block the eruption path.
- Dense bone structure: It can make eruption more difficult.
Why Is Waiting Risky?
A tooth that remains impacted does not only result in a gap in the arch. A tooth moving in the wrong direction can press on the roots of the neighboring teeth and cause resorption in these roots. This process usually progresses without pain; the patient does not notice it. For this reason, early detection and follow-up are important.
In addition, cyst development may be seen around the impacted tooth. For this reason, when an impacted tooth is detected on a radiograph, it is recommended that it be monitored even if there is no complaint.
How Is the Evaluation Done?
Two-dimensional images show the presence of the tooth; however, three-dimensional evaluation may be needed to determine its position precisely. With tomography, the direction in which the tooth lies, its relationship with the neighboring roots, its depth within the bone and the condition of its root structure can be examined in detail.
This information directly affects the treatment decision. If the position of the tooth allows it to be brought into the arch, an orthodontic plan is made; if it is in a very unfavorable position, different options are evaluated.
The Treatment Process
Creating Space
First, the area where the tooth will come is prepared with orthodontic treatment. If there is no space, trying to pull the tooth in will be fruitless.
Surgical Exposure
With a small surgical procedure, the tooth is uncovered and a small attachment is bonded to it. The procedure is done under local anesthesia.
Controlled Traction
With a system connected to the attachment, a light and continuous force is applied to the tooth. The tooth advances gradually within the bone over months.
Placement in the Arch
After the tooth becomes visible, it is brought into the correct position with orthodontic treatment and included in the bite.
Being Realistic About the Duration
Treatments for impacted teeth take longer than standard orthodontic treatments. The depth and position of the tooth significantly affect the duration. Patience is required in this process; however, in the end, bringing your own natural tooth into the arch is the most valuable gain in the long term.
Can Every Impacted Tooth Be Saved?
No, and this needs to be stated from the start. In situations such as the tooth being in a very unfavorable position, root development being complete and its shape being curved, it being fused with the bone, or the patient not accepting a long treatment process, different approaches come into consideration. In these situations, extraction followed by an implant or orthodontic space closure options are evaluated.
Signs That Allow It to Be Noticed
There are some signs that parents should pay attention to: a tooth not being visible on one side even though the same tooth on the opposite side has erupted, a baby tooth not falling out for a long time, an unexpected bulge in the gum or a change in the position of the neighboring teeth. If one of these findings is present, a radiological evaluation is recommended; since impacted teeth usually do not cause pain, no other symptom may appear.
Early Follow-Up in Children
The eruption path of the canines can be evaluated in the period when the permanent teeth begin to erupt. In deviations detected in this period, sometimes even extracting only the relevant baby tooth can help the tooth return to its normal path. This is one of the rare opportunities in which the problem can be solved without the need for a surgical procedure, and it is only caught with early follow-up.
Frequently Asked Questions
No. If its position is suitable, it can be brought into the arch; monitoring or extraction are also options that are evaluated.
It is usually painless; for this reason, it is noticed with a radiograph.
It is usually a limited procedure done under local anesthesia.
Mild sensitivity during the periods when force is applied is normal.
Alternative plans are evaluated; this possibility is shared from the start.
It is possible in some cases; however, the likelihood of success may decrease with age.
An impacted tooth is not a lost tooth.
Let us evaluate the position of the tooth three-dimensionally and determine your options. Contact us to book an appointment; let us create your plan at DijiDent Oral and Dental Health Polyclinic.
This content is for general information purposes. The treatment decision and the expectation of success are determined after clinical and radiological evaluation.
