What impaction means
A tooth is impacted when it is formed but cannot come through into the mouth, either because there is no space for it or because it is pointing the wrong way. Wisdom teeth are the most common. Upper canines are the ones that matter most, because they are hard to replace and important to the bite.
The two options
Removal, where the tooth has no useful future: a wisdom tooth, a tooth that is badly positioned, or one that is damaging its neighbours and cannot be saved. This is covered on wisdom tooth removal when it is a wisdom tooth.
Exposure and bonding, where the tooth is worth keeping. The gum over the tooth is opened, a small bracket with a fine gold chain is bonded to it, and the gum is closed with the chain left accessible. An orthodontist then uses that chain to draw the tooth into position over the following months.
Which of the two is right depends on the tooth, its position, its condition, and your age. Younger patients respond better to being guided into place.
How the surgery runs
- A 3D scan, which is the only reliable way to see exactly where the tooth sits and which way it is facing.
- Planning with the orthodontist, where the plan is to keep the tooth, so that the bracket is placed where the traction needs to pull from.
- The surgery, under local anaesthetic, usually thirty to forty five minutes.
- Healing, about a week for the gum, before orthodontic traction begins.
Afterwards
Soreness and some swelling for two to four days, which painkillers handle. Soft food for a few days. Keep the area clean gently, including around the chain if one has been placed.
The long part is the orthodontics that follows, and that is measured in months.