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Dr H S Elmanharawy
Registered Specialist Oral Surgeon

Qualifications

Canine Exposure

What does 'impacted' mean?

This means that the tooth was prevented from coming through to the dental arch correctly by bone, fibrous tissue or another tooth.

Because the upper canine teeth are some of the last to come through, they have more potential to become impacted.

Is it common to have impacted canines?

About 2% of the population have an impacted upper canine, usually affecting one side only. Most of these impacted canines present themselves towards the roof of the mouth (the 'palate') but some impact towards the cheek.

Why does it happen?

A variety of factors can reduce the space available for a canine to come through, contributing to it becoming impacted.

Commonly, there may already be a degree of teeth crowding in the upper jaw due to a shortage of space. In some cases, there is a genetic history of canines being impacted.

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What happens if it is left untreated?

If the canine is left in its impacted position, a cyst can develop around the crown of the impacted tooth, which can become infected and can also cause damage by putting pressure on adjacent teeth.

Surgical Exposure of impacted canine is usually part of a course of orthodontic treatment and so you should seek the advice of your orthodontist regarding your particular circumstances.

How will the tooth be exposed?

First, x-ray films are used to locate the position of the canine. The overlying tissues are then surgically raised away from the tooth to allow for sufficient soft tissue and bone removal to expose the tooth adequately.

Stitches are used to put the raised tissue back in place (these are usually dissolvable). A healing pack is then placed over the exposed tooth and non-dissolvable stitches may be used to secure this. The pack and stitches are quick and easy to remove and an appointment will be arranged for this, usually one week after surgery.

How long will the operation take?

This depends on the position of the impacted canine and whether the operation is being carried out with local anaesthesia alone or with additional intravenous sedation.

An appointment for surgery under local anaesthesia usually lasts 60 minutes. When intravenous sedation is used, an appointment usually lasts 90 minutes. The longer time allows for the recovery period needed before you can be discharged home.

Will I be in pain afterwards?

You should not feel any pain immediately after the operation as the area of surgery will be numb from the local anaesthetic.

As the numbness wears off, the area might become uncomfortable and then you should take painkillers. We will supply you with these, with information about doses.

Could there be any after-effects?

This depends on the operation. If there are any issues in particular to be aware of, they will be discussed with you beforehand.

There may be swelling and bruising in the area of surgery, as well as some discomfort. Bruising is usually at its most obvious two to three days after surgery and varies between patients. It normally resolves itself after 10 to 14 days.

Once the pack and stitches have been removed and the impacted tooth is exposed in the mouth, healing usually progresses quite quickly. We advise that a review appointment is arranged with your orthodontist a week to 10 days after your operation.

When can I return to work?

This depends on your occupation and how you are after your treatment. It may be possible for you to return to work the next day.

Some people need to take some time off work, especially if the operation has been carried out under intravenous sedation. We will give you appropriate advice for your particular circumstances.

After your operation

After your surgery, we will give you an information sheet with instructions to help bring about a quick recovery.

We will discuss this with you before you are discharged home, to ensure that the information is clear and understood.

The main points are as follows.

On the day of the operation
  • Get plenty of rest in the first few hours after your operation.
  • Do not rinse your mouth or drink hot fluids.
  • Relieve discomfort by taking the supplied painkillers as directed and use ice packs to reduce discomfort at the operation site.
From the following day
  • Keep your mouth as clean as possible by gently brushing your teeth as usual.
  • Use salt water mouth rinses (one teaspoon of salt in a cup of warm water) every four hours for seven days. This will help to keep the operation site clean and clear of debris.
  • Avoid smoking. The local action of nicotine in the mouth has been shown to have a detrimental effect on healing after surgery and greatly increases the likelihood of wound infection developing.
  • Continue to take the painkillers and any other supplied medications as directed and use ice packs for the next two to three days.
  • If bleeding is troublesome, you can usually control it by placing dampened gauze over the wound and applying pressure for 15 to 20 minutes (slight oozing can be expected for a short time following surgery).

If you have any other complications or require advice after treatment, please call 01793 855335 and leave a message including a contact telephone number. We will return your call as soon as we can.