Many people consider orthodontic treatment to be cosmetic in nature. However, sometimes orthodontic treatment is necessary for more than achieving a perfect smile. When teeth are impacted, orthodontic treatment is necessary to prevent more serious dental and bone problems. If you are a parent and have been told that your teen has impacted canine teeth and needs orthodontic treatment, here are a few questions you'd probably like to have answered.
What can happen if your teen doesn't get treatment?
Without treatment, your teen is at risk of having a of their jaw at some point in the future. The reason for this is because unerupted teeth can cause dentigerous cysts to form. The cysts are treated by removing them along with removing the unerupted teeth.
These cysts typically do not cause pain, but they can grow to the point that they can cause pathological fractures in the jaw bones, which can be very painful. Reconstruction of the jawbone will likely be necessary to regain normal function.
The cysts can also cause ameloblastoma, which is a benign yet painful and aggressive tumor in the jaw. Approximately 20% of ameblastoma cases are related to unerupted teeth and dentigerous cysts. Treatment of this condition typically involves surgical resection to remove the tumor, along with chemotherapy and/or radiation if it has become cancerous.
What are the orthodontic treatment options?
There are several orthodontic treatment options that are available. Your orthodontist will schedule a CBCT (Cone Beam Computed Tomography) so he or she can see exactly what is going on underneath the gums in order to make the determination of what type of treatment options will work best for your teen. Treatment options for impacted permanent canines include:
- surgically expose the impacted teeth and use orthodontic treatment to pull the exposed teeth into position with a traction hook and ligation chain
- surgically extract the impacted teeth and place a premolar substitute or a dental implant to prevent movement of the adjacent teeth during orthodontic treatment
If the impacted teeth are baby teeth, the dentist may surgically extract the impacted primary teeth and take a "wait and see" approach to see how the permanent teeth move as they replace the primary teeth. He or she may use dental spacers or braces to position the fully-erupted teeth so the unerupted teeth have room to move into position without needing bonding until they have erupted through the gums.
As with any dental or medical treatment that involves a choice of options, it's a good idea to get a second opinion before making a final decision. If the second opinion source provides you with a different treatment option, get a third opinion. Contact a local orthodontic office, like Arrowhead Family Dentistry, for more information.
What are the complications to be aware of?
According to a study of the outcome of surgical and orthodontic treatment of 82 impacted canines, none of the 54 patients in the study developed infection. However, the risk of infection is always present during and after any surgical procedure. Therefore, the dentist, oral surgeon, or orthodontist may prescribe an antibiotic for your teen to take following surgery. Be sure your teen takes this medication as prescribed.
If the impacted teeth will be exposed and a traction hook and ligation chain will be bonded to the teeth, the initial bond may fail and require rebonding at some point. The bond may prematurely come off when the sterile gauze pack is removed or at any time during the orthodontic treatment process, especially if your teen is not careful. Of course, your teen may need to change his or her eating habits and avoid chewy and sticky foods so the orthodontic treatment does not debond or break.