Exposure of impacted upper canine (eye tooth)

What is an impacted canine tooth?

The upper canine, or eye tooth, normally erupts (comes through the gum) into the mouth between the ages of 11 and 13 years. Sometimes, one or both of these teeth develop in the wrong position. Often, they lie across the roof of the mouth behind the front teeth.

Why do I need treatment?

Because one or the other of your upper canine teeth is in the wrong place and as part of your ongoing orthodontic treatment, it is necessary to help the tooth grow normally. If left alone the tooth will not grow normally and may either damage the roots of the front teeth or push them out of position.

What does the treatment involve?

Enabling the tooth to grow normally involves a minor surgical procedure. This is usually takes place while you are under general anaesthetic (asleep). You will normally be able to go home on the same day as the surgery.

While you are asleep, the gum lying over the canine tooth will be removed or pushed out of the way. Occasionally, some of the bone surrounding the crown of the tooth also needs to be removed.

How will the tooth be put into the correct position?

Once the canine is exposed 1 of 3 things will usually happen under the same anaesthetic. This will have been discussed with you during your first appointment and is explained below:

A pack

A special gum dressing pack is placed over the tooth after it is exposed. This will allow the tooth to start to move into your mouth. The pack is kept in position with stitches and will be removed after a few weeks. You must be careful not to dislodge the pack. If this happens you should contact the department for advice.

A plate

A small window will be cut in the gum over the tooth and a plastic plate put in place to cover the area. This will allow the tooth to start to move into your mouth. This plate is held in your mouth with clips that attach to some of your back teeth. It is important that you wear the plate all the time except when you take it out to clean your teeth. Without the plate, the gum may grow back, making it difficult for the orthodontist to move the tooth into position.

Bracket and chain

A small bracket is glued to the tooth. Attached to this is a chain which your orthodontist can then use to pull the tooth into the correct position over the next few months. The chain is quite delicate and therefore it is important to be careful when eating for the first few weeks after surgery.

Stitches are often needed at the operation site. However, these are usually dissolvable and disappear in 2 to 3 weeks.

Will there be much pain or swelling after the procedure?

None of the above procedures are particularly painful but you will experience some soreness. There is usually very little in the way of swelling.

Any pain or discomfort is easily dealt with by simple pain relief such as ibuprofen or paracetamol taken regularly.

Will I be given instructions after the procedure?

Full details for aftercare will be given following the procedure.

Going home

If you have had a local anaesthetic, you will be able to return home straight after your appointment. If you have had a general anaesthetic or sedation, it is essential that someone takes you home and that there is a responsible adult to stay with you for 24 hours. For this period of time, you should not:

• Drive a car, motorbike or ride a bicycle
• Drink alcohol
• Operate machinery or do anything requiring skill or judgement, including cooking
• Make important decisions or sign any documents

When can I return to school?

It is advisable to allow a couple of days off school after a general anaesthetic and a few further days off any vigorous exercise or sports.

Will I need another appointment?

You will need to return a few weeks after surgery to have the area checked by your orthodontist or surgeon. Further appointments after this will be necessary for your on-going orthodontic care.

Who to contact if you have concerns after the surgery

Most people have very few problems and following the advice on this page is usually all that is needed. Therefore, we do not always review patients following surgery.

Gloucestershire Hospitals Switchboard

Tel: 0300 422 2222

When prompted, ask for the Operator, then ask to be put through to the ‘On call Senior House Officer’ for the Oral and Maxilofacial Department.

Alternatively, you can contact your registered dentist for advice.

Other useful contact information

New and follow-up clinic booking enquiries

Tel: 0300 422 6940

Monday to Friday, 9:00am to 4:30pm

Minor surgery (local anaesthetic with/without sedation) booking enquiries

Tel: 0300 422 3197

Monday to Friday, 9:00am to 4:30pm

Inpatient and Day Surgery Unit booking enquiries

Tel: 0300 422 8191

Monday to Friday, 9:00am to 4:30pm

Website

For further information, please visit the Oral & Maxillofacial Surgery webpage:

www.gloshospitals.nhs.uk/our-services/services-we-offer/oral-maxillofacial-surgery/

Feedback

We would welcome your feedback regarding your treatment. Please visit www.nhs.uk

Scroll to the bottom of the page and select the ‘Contact us’ link. On the next page, select ‘Give feedback or make a complaint’ then select the link below the heading ‘Give feedback about an NHS service.

Feedback can also be left on the Gloucestershire Hospitals twitter account: @gloshospitals