The primary dentition or "baby teeth" begin to fall out at approximately 6 years of age due to development of the underlying permanent dentition or "adult teeth." This process continues into early adolescence.
Factors such as dental crowding, developmental delays, and fusion of the overlying primary tooth to the jaw bone can often result in impaction or lack of natural eruption of the developing permanent tooth. The teeth most frequently affected are the maxillary canines/cuspids also commonly referred to as the "eye teeth."
Usually impacted teeth can be salvaged with orthodontic and surgical intervention. Typically, the orthodontist will place braces and begin to create space for surgically aided eruption of the impacted tooth. The oral surgeon will then expose the impacted tooth and bond a modified orthodontic bracket to the crown of the impacted tooth. This modified bracket has a small chain affixed to which the orthodontist can attach elastic devices and apply eruption assistance forces to the impacted tooth after surgery.
The surgical exposure and bonding of the modified orthodontic bracket is typically performed in the office setting under IV sedation/general anesthesia. Some swelling and discomfort is to be expected, but is typically very mild. Upon visual inspection, the effects of the surgery may not be very noticeable to the lay observer. Patients can expect to see a small portion of the attached chain protruding through the gum tissue. Your surgeon will usually secure this chain to one of the brackets on a neighboring erupted tooth will a small wire, which the orthodontist will remove at your next office visit following surgery. Resorbable suture materials are used during surgery and will not require removal. Routine oral hygiene including tooth brushing may be resumed immediately following surgery, however, care should be taken to avoid traumatizing the gum tissue.