Eye-teeth are one of the last permanent teeth to erupt and often become impacted due to a lack of space for all of the permanent teeth to fit properly. Impaction means the tooth is ‘locked’ in the bone or gum tissue because of insufficient space.
There are many different degrees of impaction. In every case, we start your treatment by creating proper space for the impacted tooth. Once sufficient space is created, we take an x-ray to assess whether or not the tooth has started to come in on its own. If there is no evidence of tooth movement on your x-ray after sufficient space has been created, the tooth may require a small surgical procedure called an exposure. Surgical exposure of eye-teeth is performed by an Oral Surgeon at an additional fee to your Orthodontic treatment.
Exposure of an eye-tooth, is a relatively simple procedure in which the surgeon provides you with special medication (intravenous sedation) so you experience no discomfort or have any memory of the procedure. The surgeon makes a little incision through the gum tissue and places a brace directly on the impacted tooth under the gum tissue. After approximately 1-3 weeks of healing, we use very gentle pressure with an elastic attached to your orthodontic wire to slowly pull the tooth down into place. Depending on the original location and degree of impaction, it may take 3-12 months to slowly pull the eye-tooth down into its proper position.
What should I do to prepare myself before and after the exposure?
It is extremely important that you maintain excellent oral hygiene (brushing and flossing) before and after the procedure. We recommend that you start taking some Advil (Ibuprofen) 12 hours before the procedure (1-2 tablets every six hours) following the drug manufacturers instructions. You can continue taking Advil for approximately 48 hours after the procedure is completed, along with application of ice (wrapped in a towel, alternating 10 mins on and off) to your cheek area to prevent or decrease discomfort.
If some discomfort is experienced after the first day, application of a moist warm towel compress to your cheek can be used to sooth the area, along with proper intake of fluids such as water, juice, and plenty of rest.
Once the procedure is completed, the surgeon may provide you with an anti-bacterial mouth rinse for one week. It is important to use this rinse as instructed and take it for the full week to prevent infection or poor healing of the exposure area. In addition, to the anti-bacterial mouth rinse, we strongly recommend frequent warm salt water rinses to aid with healing for a period of two weeks along with thorough brushing and flossing. In order to prevent plaque and bacteria build-up around the area of the exposure, it is extremely important to brush over this area gently every time you brush, starting a few days after the exposure.
Please remember, that this area may be sore to brush for a couple days but it will help ensure healthy and rapid healing of the tissue. All you have to do now is sit back and watch your new eye-tooth magically appear!