Exposure of Impacted Teeth
What is an impacted tooth?
An impacted tooth simply means that it is “stuck” and cannot erupt into function. Patients frequently develop problems with impacted third molar (wisdom) teeth. These teeth get “stuck” in the back of the jaw and can develop painful infections, among a host of other problems (see Wisdom Teeth under Procedures). Since there is rarely a functional need for wisdom teeth, they are usually extracted if they develop problems. The maxillary cuspid (upper eyetooth) is the second most common tooth to become impacted. The cuspid tooth is a critical tooth and plays an important role in your “bite”. The cuspid teeth are very strong biting teeth and have the longest roots of any human teeth. They are designed to be the first teeth that touch when your jaws close together so they guide the rest of the teeth into the proper bite.
Normally, the maxillary cuspid teeth are the last of the “front” teeth to erupt into place. They usually come into place around age 13 and cause any space left between the upper front teeth to close tighter together. If a cuspid tooth gets impacted, every effort is made to get it to erupt into its proper position. The techniques involved to aid eruption can be applied to any impacted tooth in the upper or lower jaw, but most commonly they are applied to the maxillary cuspid (upper eye) teeth. Sixty percent of these impacted eyeteeth are located on the palatal (roof of the mouth) side of the dental arch. The remaining impacted eye teeth are found in the middle of the supporting bone, but are stuck in an elevated position above the roots of the adjacent teeth, or are out to the facial side of the dental arch.
Early Recognition of Impacted Eyeteeth Is the Key to Successful Treatment
The older the patient the more likely an impacted eyetooth will not erupt by natural forces alone, even if the space is available for the tooth to fit in the dental arch. A panoramic x-ray, along with a dental examination, will help determine whether all the adult teeth are present or if some adult teeth are missing.
Treatment may require referral to an oral surgeon for extraction of over-retained baby teeth and/or selected adult teeth that are blocking the eruption of the all-important eyeteeth. The oral surgeon will also need to remove any extra teeth (supernumerary teeth) or growths that are blocking the eruption of any adult teeth.
Impacted tooth success by patient’s age:
- 11-12 years old – with space opened for eruption, good chance for success.
- 13-14 years old – the impacted eyetooth will not erupt by itself, even with the space cleared for its eruption.
- Over 40 years old – much higher chance that the tooth will be fused in position. The only option is to extract the impacted tooth and replace it with a crown on a dental implant or a fixed bridge.
What happens if the eyetooth will not erupt when proper space is available?
In cases where the eyeteeth will not erupt spontaneously, the orthodontist and oral surgeon will work together to get these teeth to erupt. Each case must be evaluated on an individual basis, but treatment will usually involve a combined effort between the orthodontist and the oral surgeon. The oral surgeon will expose and bracket the impacted eyetooth.
The goal is to erupt the impacted tooth and not to extract it. Once the tooth has moved into its final position, the gum around it will be evaluated. In some circumstances, there may be some minor “gum surgery” required.
Exposure and Bracketing of an Impacted Cuspid












What to expect from surgery to expose & bracket an impacted tooth
The surgery to expose and bracket an impacted tooth is a very straightforward surgical procedure that is performed in the oral surgeon’s office. For most patients, it is performed using laughing gas and local anesthesia. In selected cases it will be performed under IV sedation if the patient desires to be asleep, but this is generally not necessary for this procedure. If the procedure only requires exposing the tooth with no bracketing, the time required will be shortened by about one half. These issues will be discussed in detail at your preoperative consultation with your doctor.
Refer to Preoperative Instructions under Surgical Instructions on this website for a review of any details. Simply call Silver Creek Oral Surgery at Silver Creek Oral Surgery, Everett WA Phone Number 425-224-4661 if you have any questions.
Silver Creek Oral Surgery
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I just want to thank eve for your hard work and your patience with me. I honestly didn’t know how I would get through it, but it’s been two weeks since we did the surgery and I still can’t believe it went so smoothly, (knock on wood). Thank you Dr. Stivers. With deepest gratitude and respect to the whole team (silver lake and seattle), Svetlana Mendyuk
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My teeth were all impacted so my wisdom teeth was a little more of an invasive process. Dr. Stivers and the rest of the staff made me feel so comfortable throughout the whole procedure. The receptionists continuously checked in on me post surgery to make sure I was doing okay after. I was having pain afterwards and they made it a point to see me right away to figure out what was going on and ease my healing process. I went to this place initially for convenience bu I'm truly so content with my choice and experience I received at Silver Creek. The staff is amazing and the Dr is the best! Definitely recommend! Thanks again, you guys!
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The level of professionalism is in every detail. Her recovery time was just as they explained and she didn't experience any complications. The post operative instructions were clear and every precaution to ensure a smooth recovery was addressed. We are so grateful that McKeighla was in such wonderful hands. Thank you so much!
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As before they took good care of me and I am pleased with the results.
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The cat's meow! Totally top drawer. Awesome experience! Big shout out to my dentist for referring me to you alls practice.
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Friendly and competent staff.
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I was nervous about getting my wisdom teeth removed but Dr. Stivers and Nurse Tina were a dynamic duo who were thorough, informative and entertaining! The rest of the staff was also very helpful and cared for me. They all made me feel very calm about my procedure.
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I had a broken tooth that needed to be extracted and the staff and especially the doctor put me at ease and walked me through the whole process. I was given a valium since I have bad anxiety and it did the trick. I totally recommend this place!! Definitely worth it!
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Professional, helpful, and courteous every step of the way. Everything was explained very clearly.
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Doctor Mark is truly amazing. I have had a lot of dental experiences that were disasterous. My own Dentist did not have time to see me when I really could have died. I have never seen that with this dentist. He takes his time and you feel that he is not rushing anything and you know you are the most important person there. The Best:-)
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We refer our patients to Dr. Stivers. Their feedback has always been positive. His staff are always helpful, friendly, and go the extra mile for our patients we send to them.
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Wonderful experience, which isn’t usually synonymous with dentistry
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Surgery and healing went as planned and we were happy with the results. Appreciated follow up call to check a couple days after surgery.
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Procedure was much smoother than I anticipated, I’m very happy with the results!
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Friendly, I was put at ease about my surgery. I would recommend this office to all of my friends.
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I am so pleasantly surprised at how well my experience at Silver Creek OMS went. I've been terrified of having my wisdom teeth removed for YEARS and Dr. Stivers and his staff made it quick and easy. I'm only on day two of recovery but I already feel like my old self again (minus the swelling and limited food options!). Everyone at the office was so friendly and approachable and they really made a nerve-racking experience quite tolerable. 🙂
- Anjelica S
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Staff went out of their way to make me (a dental phobic) comfortable and confident in the procedure. I have already recommended them to my friends.
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