How Does an Oral Surgeon Remove an Impacted Tooth?

Impacted Tooth North TXAn “impacted” tooth is simply one that is submerged beneath the gum tissue and/or bone, and either can’t or hasn’t yet been able to break through or erupt into function.

Depending on the location and severity of the impacted tooth, treatment may not be necessary. However, in many cases surgical intervention is required to prevent other teeth from becoming damaged or displaced along with other reasons.

If removal of an impacted tooth is required, treatment will generally consist of one or more of the following procedures:

  • Extraction of Extra Teeth – Extra teeth–called “supernumerary” teeth—is indicated usually in cases where the tooth is inhibiting normal positioning or eruption of another permanent tooth.  Likewise a supernumerary tooth may be removed if it is impeding orthodontic movement.

    Surgical Exposure for Orthodontics
    – When considering teeth that are slow to erupt (what we call “delayed eruption”), often times the orthodontist will need the impacted tooth to be “surgically exposed”.  This procedure involves removing gum tissue and bone to expose the impacted tooth. Once the tooth is accessible, Drs. Stewart or Michael will bond an orthodontic bracket and chain to the exposed tooth. The chain will then be temporarily attached to an appliance previously placed by the patient’s orthodontist. Depending on the patient, the impacted tooth may be left uncovered by suturing the gum above the tooth or making a window in the gum covering the tooth. More frequently though, the gum is returned to its original location and sutured closed with the chain remaining visible through a small hole in the gum. The first 24-36 hours post-surgery, patients may experience a limited amount of bleeding from the surgical sites. Although some discomfort is to be expected, most patients are able to manage their pain with Tylenol or Ibuprofen. Additional details on what to expect post-surgery can be found here.
  • Extraction of the “Ankylosed” Impacted Tooth – Occasionally, some teeth are found to be essentially fused to the surrounding bone (called “Ankylosed” teeth).  Despite extensive efforts, these teeth are nearly impossible to move and usually must be extracted.  Extraction of Ankylosed teeth is generally a fairly difficult and technically challenging procedure to perform.  Ankylosed tooth removal should only be attempted by those well-trained to do so.

For your convenience and comfort, Drs. Stewart and Michael perform these procedures in one of our four office locations (Denton, Plano, Decatur, Gainesville). For most patients who want to be asleep during the procedure, it is performed under IV sedation. This route is also recommended for patients with mild to moderate anxiety; however, another option is to perform the surgery using Nitrous Oxide sedation and local anesthesia (numbing medicine).

At Texas Oral Surgery Group, we understand that surgery is never a minor consideration, and we want you to be confident knowing that we put our patients’ well-being above all else. That’s why our entire surgical team is Dental Anesthesia Assistant National Certification Examination (DAANCE) certified. This is the highest level of certification granted by the American Association of Oral and Maxillofacial Surgeons (AAOMS). Additionally, while most procedures today are office-based, Drs. Stewart and Michael maintain privileges at Medical City Plano, a Level I Trauma Center located in Plano, Texas.

Drs. Stewart and Michael and the entire team at Texas Oral Surgery Group are committed to delivering quality patient care and are happy to answer any questions. Please don’t hesitate to reach out to any of our four locations (Denton, Plano, Decatur, Gainesville).


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