Procedures
Bonding and Brackets After Exposure
Bonding and Brackets After Exposure
An impacted tooth occurs when a permanent tooth fails to erupt into its proper position.
It is a common problem encountered during orthodontic treatment. It’s critical to address impacted teeth as soon as possible.
Tooth exposure is a surgical procedure used to prepare a tooth for bonding and bracketing when the tooth is partially or entirely hidden below the surface of the gum tissue.
An extraction may also be necessary to remove extra teeth blocking the eruption of adjacent teeth or if adult teeth do not have the proper space to erupt. If a baby tooth is present, it will also be removed simultaneously.
The process is a collaborative treatment between the orthodontist and oral surgeon. Each case is evaluated individually.
AZ Max Oral & Maxillofacial Surgeons offers bonding and brackets after exposure in Mesa, North Mesa, Queen Creek, Show Low and Tempe, AZ.
Key Takeaway
Bonding and bracketing after tooth exposure is a collaborative procedure between orthodontists and oral surgeons to guide impacted teeth into proper alignment. The process includes surgical tooth exposure, bonding materials or brackets, and careful orthodontic adjustments over time to ensure a functional and aesthetically pleasing result.
Why is Tooth Exposure Surgery Necessary?
One of the main reasons an impacted tooth needs to be exposed is because it cannot be bonded or bracketed in its usual location.
An impacted tooth may remain unerupted due to:
- Dense bone blocking its eruption.
- Lack of space in the dental arch.
- Abnormal growth patterns or positioning.
- The presence of baby teeth or extra teeth impeding its path.
Failure to address an impacted tooth can lead to complications such as misalignment, discomfort while chewing, and even long-term damage to adjacent teeth.
Commonly Impacted Teeth
The most frequently impacted teeth requiring exposure and bonding/bracketing include:
- Upper canine teeth (cuspid): The cuspids, also known as ‘eye teeth,’ are critical teeth in the dental arch. They must erupt into their proper position as they play an important role in your bite and alignment.
- Premolars and molars: Often affected by dense bone or lack of space.
- Wisdom teeth: While commonly extracted, unerupted wisdom teeth may occasionally require exposure for alternate treatment.
Exposing a Tooth for Bonding/Bracketing
Bonding and bracketing an impacted tooth require a specialized procedure and close coordination between an oral surgeon and an orthodontist. This process is often necessary for proper orthodontic treatment and achieving the desired results.
The exposure and bonding/bracketing procedure involves two key steps:
- Surgical tooth exposure: An oral surgeon uses specialized tools to remove gum tissue and any bone that may be blocking the impacted tooth. This allows access to the hidden tooth in its original location. In some cases, dense bone or additional gum tissue may also be removed to aid healing and movement.
- Bonding/bracketing procedure: Once the tooth is exposed, a bonding material or orthodontic bracket is attached to the surface of the tooth. This forms the foundation for orthodontic wires, which gradually guide the tooth into its ideal position over time.
What Are Brackets?
An orthodontic bracket is a small metal or ceramic piece attached to the teeth using bonding materials.
The bracket serves as a foundation for bonding wires, which guide teeth into their correct position during orthodontic treatment.
An orthodontic bracket can be placed on any tooth experiencing abnormal growth patterns or misalignment. They may be combined with other orthodontic devices, such as expanders or headgear.
Activating the Tooth
Once the surgical site has healed and the bonding/bracketing material has been placed on the exposed tooth, you will need to see your orthodontist to activate the tooth for the eruption process.
The orthodontist may attach a rubber band to the miniature gold chain attached to the bracket to allow for proper eruption of the tooth. This is typically done 1-14 days after the initial procedure, depending on your consultation with the orthodontist. This is a controlled, slow process that will take several months.
Your orthodontist will later attach a wire to the bonding/bracketing material, which will be gradually tightened to adjust the position of the tooth over time into its ideal position. This process will continue until your orthodontist is satisfied with the alignment of your teeth.
Recovery and Aftercare
Bleeding
Proper oral hygiene is essential after surgery to prevent infection and promote healing.
Gentle tooth brushing around the surgical site and rinsing with an approved mouthwash can help maintain cleanliness.
Discomfort after surgery is common and can be managed with over-the-counter pain relievers.
Manage Swelling and Bleeding
- Swelling: Some facial swelling is normal after the surgical exposure of an impacted tooth. The degree of swelling will be different for each individual. For the first 24–48 hours, use ice packs in 20-minute intervals. Wrap the ice pack in a cloth to protect your skin.
- Bleeding: Minor bleeding is normal and should subside within a few days. Persistent bleeding may require consultation with your oral surgeon. In rare cases, more significant bleeding may occur and may require treatment with stitches or pressure dressings.
Diet
After oral surgery for an impacted tooth, it is important to stick to a soft diet for several days after surgery.
This will help minimize discomfort and allow the area to heal properly. Avoid hot foods, things like hard candy and chewing gum, and sharp food items like chips or seeds, as these may increase the risk of bleeding or swelling after surgery.
Sedation and Comfort
So that the patient experiences minimal discomfort during the surgical exposure, IV sedation or general anesthesia will be used.
- IV sedation: This type of sedation is administered through an IV, and it helps to relax the patient and make them drowsy during the procedure. You may not be completely asleep during the procedure but will likely not remember much of it afterward.
- General anesthesia: This type of sedation is administered through an IV and puts the patient to sleep for the entire procedure.
See our blog, “Is Sedation Dentistry Safe?” for more information.
Alternate Treatment Options
In some cases, when surgical exposure and bonding/bracketing are not feasible, alternate treatments such as extraction and prosthetic replacement may be considered.
Each case is evaluated individually to determine the best approach for achieving a proper bite and visible teeth alignment.
The Best Oral Surgeons In Arizona
If you need bonding or bracketing for orthodontic treatment, talk to your orthodontist and oral and maxillofacial surgeon about the best options for your care.
At AZ Max, we make surgical exposure of an impacted tooth a quick and relatively painless procedure that can be performed in one visit.
To book an appointment at our oral surgery office in Mesa, North Mesa, Queen Creek, Show Low or Tempe, call (480) 830-5866 or complete the online inquiry form.
