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Occasionally a permanent tooth may not erupt at the proper time and may become trapped under the gums and bone. When this happens your child’s dentist or orthodontist may say that the tooth is impacted.

Regular dental visits help your dentist and orthodontist keep track of your child’s developing dentition. An impacted tooth can often be detected at an early age on dental x-rays. The most common tooth affected is the upper cuspid or “eye tooth.” Many factors can lead to impacted teeth. Commonly, lack of space or prolonged retention of primary teeth can cause a tooth to become delayed in its eruption and ultimately impacted. Teeth that remain impacted can damage the roots of other teeth and are also at risk for developing tooth related cysts and other pathologic conditions.

Impacted cuspids must be brought into their proper position through careful planning and treatment. They are best treated through a team approach. Your orthodontist, and oral surgeon each add special skills and expertise necessary to appropriately diagnose and treat impacted teeth.

Often a three-dimensional x-ray is needed to assess the exact position of the impacted tooth. Your child may only need timely extraction of primary teeth and orthodontic treatment to provide space for the permanent tooth; however, a surgical procedure together with orthodontic treatment is usually required to expose the impacted permanent tooth and to help bring it into position.

Temporary Anchorage Devices

In recent years small Titanium screws referred to as “temporary anchorage devices” (TADs) have been used as an adjunct in orthodontic treatment. They can be placed in numerous locations around your teeth. They provide a stable anchorage point (as opposed to using teeth as anchorage) which can be used to place traction on teeth that need to be moved without risking the unwanted movement of other teeth that are already in good position. If your dentist or orthodontist feels that you may benefit from TADs he/she will refer you to us for a consultation so we can discuss the surgical placement of TADs in detail. Once your orthodontic treatment is completed we will then remove the TADs.

TAD Canine Retraction Screw

Frenectomy surgery is a simple procedure designed to eliminate the presence of a frenum in a patient’s mouth.

Depending on where the frenum is located, it can result in a gap between the two upper front teeth, recession of the gums or limited movement of the tongue.




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