Oral surgery - Surgical uncovering of teeth

This information is designed to help your understanding of the condition where an upper canine or “eye tooth”, or any other tooth fails to grow through normally into the mouth and remains under the gum.

The problem

The upper canine, or “eye tooth”, normally appears in the mouth between about the ages of 11 and 13.

Sometimes the teeth don’t develop in the correct position and the upper canine is the most common tooth to be affected in this way.

Either one or both sides might be affected. Often, they will lie across the roof of the mouth behind the front teeth.

Why is treatment required?

Upper canine teeth have long roots making them strong teeth. They are important teeth both for biting and for the appearance of a normal smile.

Sometimes they may be left alone and will not appear for many years, possibly a whole lifetime.

They can, occasionally, damage the roots of other front teeth or push them out of position. They can stop the orthodontic brace movement of other teeth.

Very rarely, cysts can develop around them. Treatment is always provided as part of on-going orthodontic brace treatment to help the teeth appear normally in the mouth.

What does the treatment involve?

Helping the tooth to grow through into the mouth involves a minor surgical operation. This may be carried out under local anaesthetic, an injection to freeze the gum.

Often it takes place under a general anaesthetic being put to sleep and going home the same day.

Depending on the exact position of the buried tooth; one, or more of the following procedures may be carried out:

1. If the tooth lies near the outside of the line of teeth, near the lip, the gum can be moved up and re-positioned, being stitched in the new position uncovering the top of the tooth.
2. If the tooth is in the roof of the mouth a small window of gum is removed plus some bone from the palate if it is necessary. The gum is stitched back together. In many cases a dressing plate which is similar to a removable brace will be made before surgery.
   Following surgery, the dressing plate will be placed in the mouth covering the palate; it protects the uncovered teeth, preventing the gum from growing back over them. This is worn full time and after two days can removed for cleaning.
3. If the tooth is very deeply buried then often the gum over it will be lifted up, the tooth is uncovered and a gold chain will be glued onto the top of it. The gum is then stitched back. The orthodontist can use the chain to pull the tooth gradually into the correct position. Pulling can usually begin a couple of weeks after surgery when healing is complete.

The stitches used in the treatments are dissolvable ones - you do not have to have them taken out.

What are the after effects?

Following surgery there is usually very little swelling but there will be some soreness. This is normally taken care of with simple painkillers such as paracetamol. It is not usually necessary to take antibiotics.

A review appointment should be made 1 week following surgery with an orthodontist

Risks

• Once uncovered, the teeth may:
• Fail to move
• Have a poor appearance
• In a very small number of cases re uncovering may be needed if the gum grows back over the tooth
• Prolonged bleeding is rare but if it occurs, pressure with a cotton handkerchief or swab for at least 10 minutes usually stops it

Contact information

Appointment enquiries - 0161 206 4100
Email: Oral.surgery2@nca.nhs.uk

The information in this leaflet has been discussed with the patient/parent/guardian.