Impacted Canine Exposure & Tooth Bracketing

An impacted tooth is a tooth that has not erupted into the mouth properly and is stuck underneath the gum tissue. The most common type of impacted tooth is the canine tooth. These teeth typically come in around 11-12 years of age. 

Our team of experienced surgeons has years of experience handling this. If you are looking for an oral surgeon in Boulder, CO, Louisville, CO, Broomfield, CO, Longmont, CO, or Lafayette, CO call us at (303) 444-2255 and schedule your consultation.

What Is an Impacted Canine or Cuspid?

An impacted canine or cuspid (maxillary cuspid tooth) is a tooth near the front of your upper jaw that doesn’t come into the mouth in the right position or at the right time during puberty. These teeth are critical to proper jawbone development and having a proper bite. 

For some people, the canines never come into the mouth on their own. They become impacted, meaning they’re trapped beneath the gum tissue or bone. The canine tooth is the second most common tooth to become impacted after the wisdom teeth.

Risks of an Impacted Canine Tooth

The most common problems associated with impacted canines are:

  • Infection. Impacted canines are more prone to infection than other teeth because they are hidden beneath the gum tissue and are difficult to keep clean.
  • Damage to adjacent teeth. When an impacted canine does not erupt into the mouth properly, it can cause damage to the teeth on either side of it. This is because the impacted canine will be pushing against those roots as it attempts to come in, eventually causing root resorption, migration of the other teeth, or loss of surrounding bone.
  • Delayed eruption of other teeth. If an impacted canine is not treated, it can delay the eruption of other teeth in the mouth. This is because the impacted canine will be taking up space that should be used by other teeth.
  • Problems with jaw alignment. If left untreated, an impacted canine can cause problems with jaw alignment. Impacted teeth can affect the proper vertical and horizontal growth of the upper jaw. 


To diagnose an impacted canine, your dentist or oral surgeon will take a medical history and perform a physical examination of your mouth. They will also take x-rays to determine the position of the tooth and check for any damage to adjacent teeth. This information will help them develop a treatment plan. Every case will be looked at on an individual basis, as treatment plans vary from patient to patient.

Exposing and Bracketing a Tooth

The goal of treatment for an impacted canine is to expose the tooth so it can be properly aligned with the rest of the teeth. This simple surgical procedure is called exposure and bracketing. 

Prior to seeing the surgeon, an orthodontist will insert a temporary wire arch into the upper arch. The chain from the bracket will be attached to this temporary wire. 

Your oral surgeon will make a small incision in the gum tissue to access the tooth and make space for the eruption path. If a baby tooth is present, it will be extracted at this time. Once the tooth is exposed, an orthodontic bracket will be placed on the exposed tooth. The bracket has a very small gold chain that is then connected to a wire, which will be used to pull the tooth into the correct position to allow it to have a proper eruption. This process can take several months to complete.

You will need to return to see your orthodontist within the first 3 weeks to activate the tooth eruption process. After the tooth has been moved into the proper position, the bracket and wire will be removed, and you will be given a retainer to wear at night to keep the tooth in place.

Sedation Options

Since surgery is required to expose and bracket an impacted canine, sedation options will be discussed to help you relax during the procedure. The type of sedation you receive will depend on your medical history and the extent of the procedure. Sedation can help to ease anxiety and make the procedure more comfortable. 

Several types of sedation methods are available including local anesthesia, laughing gas (nitrous oxide), intravenous (IV) moderate sedation, and IV deep sedation. Your oral surgeon will discuss sedation options with you and determine what is the best option for your particular procedure.

Post-Procedure Care

You will be given specific instructions on how to care for your mouth after surgery. These will include instructions on oral hygiene, diet, activity, and medications. 

You may be prescribed pain medication to help control any pain you may experience. It is important to take this medication as directed and only take the recommended amount. Taking more medication than what is recommended can lead to serious side effects.

You should avoid eating hard or crunchy foods, as well as hot drinks for at least 24 hours after your surgery. This will help to prevent any discomfort or irritation at the surgical site. 

Other remedies to help during recovery are:

  • Apply gauze to stop any bleeding on the surgical site. Bite down firmly on the gauze for 30 minutes to control any bleeding. The bleeding should subside after approximately 3-6 gauze changes.
  • Apply an ice pack to the outside of your cheek for 20 minutes at a time to help with the swelling. Do this several times a day for the first 24 hours after surgery.
  • You may also have some bruising around your face and neck. This is normal and will resolve on its own within a few days. This bruising results from the blood vessels being disrupted during surgery but is nothing to be concerned about.

Most people recover from surgery within a few days and experience minimal discomfort.

Risks Involved in Exposing and Bracketing

As with any surgery, there are certain risks involved in exposing and bracketing a tooth. These risks include:

  • Infection. There is always a risk of infection after any type of surgery. This risk can be minimized by practicing good oral hygiene.
  • Dislodgement of the chain and bracket. Contact sports and heavy manipulation around the surgical site should be avoided after surgery for the first week. If the chain and bracket are dislodged, we will have to perform another procedure for replacement. 
  • Excessive bleeding. While it is normal to experience some bleeding after surgery, excessive bleeding can occur in rare cases.
  • Allergic reaction. In rare cases, people can have an allergic reaction to the anesthesia or other medications used during surgery. If you experience any of these symptoms after surgery, it is essential to contact your oral surgeon immediately.

Discuss these risks with your oral surgeon before surgery so you are fully aware of what to expect.

Best Oral Surgeons Boulder, CO

If you have impacted canine teeth and need tooth bracketing, contact our team at Foley and Le Oral Surgery. Our team of highly skilled and experienced oral surgeons in Boulder, CO, can help you with this common dental procedure. We will work with you to develop a tailored treatment and recovery plan for you

Contact (303) 444-2255 to schedule a consultation.We are located at 1420 28th St, Suite 100, Boulder, CO.

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Frequently Asked Questions

Does tooth exposure surgery hurt?

The level of discomfort you experience after surgery will depend on the type of anesthesia used and your pain tolerance. Most people report minimal discomfort after surgery, which can be controlled with over-the-counter or prescription pain medication.

What to eat after tooth exposure?

You should avoid eating hard or crunchy foods, as well as hot drinks for at least 24 hours after your surgery. This will help to prevent any discomfort or irritation at the surgical site.

Does insurance cover tooth exposure and bracketing?

Most insurance companies will cover at least a portion of the cost of this type of surgery. Our team will be happy to assist in helping to determine the coverage provided with your insurance plan. 

How long does it take to pull a canine down with a chain?

The length of time it takes to pull a canine tooth down with a chain will depend on the severity of the impaction and the individual patient. In most cases, it will take several months to see results.

How long does it take a tooth exposure to heal?

Most people recover from surgery within a few days and experience minimal discomfort. Swelling and bruising are common and should resolve on their own within a week.

How long does the procedure take?

The actual procedure to expose and bracket a tooth typically takes less than an hour or two. However, the total length of time you will be at the oral surgeon’s office will depend on the type of anesthesia used and how you feel after the surgery.

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