Occasionally minor oral surgery procedures are necessary in conjunction with orthodontic treatment. Often the more simple procedures such as removal of erupted teeth because of decay or crowding can be comfortably managed by your Dentist using local anaesthetic (injection) at the Dental Surgery. More complex surgical procedures such as removal of impacted or unerupted teeth are often arranged to be done under a short general anaesthetic (day surgery) by either your Dentist or a specialist Oral & Maxillofacial Surgeon at a private hospital. These arrangements are made according to individual patient preferences and recommendations from the Orthodontist and Dentist. Oral surgery procedures include:
Extraction of teeth: As mentioned above, erupted teeth might need to be removed because of decay, poor long term prognosis (stability), over-retention of deciduous (baby) teeth or very occasionally to correct crowding.
Extraction of impacted teeth: Wisdom teeth are the most likely teeth to become impacted which is where they remain completely or partially unerupted because of inadequate space for eruption or ectopic (abnormal) position. Surgical extraction of wisdom teeth is generally recommended due to concern regarding recurrent infection of surrounding gum, not because they cause crowding.
Extraction of ankylosed teeth: Permanent or deciduous teeth can become ankylosed which is where they are fused to surrounding bone and either remain unerupted or don’t continue to erupt to maturity alongside adjacent teeth. Ankylosis can be idiopathic (no apparent cause) or due to trauma, and ankylosed teeth cannot be orthodontically repositioned or aligned.
Ligation of impacted teeth: If we decide to orthodontically erupt impacted teeth into normal alignment, most commonly the upper canines, the unerupted impacted tooth can be surgically ligated, which usually involves attachment of a short length of fine gold chain to the tooth so that the tooth can be guided into alignment using braces.