Wisdom teeth, or third molars can be troublesome and painful if there is not enough space for the teeth to completely erupt into the mouth into a useful position. Wisdom teeth that have not surfaced out of the bone through the gums into the mouth are called impacted teeth and usually will need to be removed to prevent gum disease and other types of infections and cysts from forming.

Sometimes other teeth do not erupt into the mouth properly and this is generally noted when a child is in what we call the “mixed dentition” phase (when there are some baby teeth and some adult teeth). Impacted teeth can occur anywhere in the mouth: incisors, canine teeth, bicuspids and molars. In most cases, once the child is under the care of an orthodontist, Dr. Banks will assess the position of the tooth in the jaw precisely with a Cone Beam CT scan in the office, and will show the patients and the parents where the tooth is and determine whether it is possible to move the tooth with orthodontic traction or whether the tooth is so badly positioned in the jaw that it must be removed.

If the impacted tooth is a candidate to be moved orthodontically, Dr. Banks will discuss and plan a procedure to expose the tooth crown and to bond a special orthodontic bracket with an attachment for the orthodontist to use to move to tooth into its correct position. These procedures are performed in the office with the comfort of sedation anesthesia.

If the unerupted or impacted tooth cannot be moved orthodontically, then Dr. Banks will discuss and plan a surgery to remove the unerupted or impacted tooth, and together with the orthodontist, Dr. Banks will discuss options for future tooth replacement.

Extra teeth: Some patient have extra teeth, called supernumerary teeth. These can occur anywhere in the mouth and usually need to be removed, especially when the presence of the extra tooth is impeding the eruption or causing damage to the other teeth. The supernumerary tooth could be impacted, as in the case of a mesiodens, an extra tooth that forms in between the two upper front teeth. If the supernumerary tooth is impacted Dr. Banks will assess the position of the superneumerary tooth in the jaws with a Cone Beam CT Scan in the office, so that surgical removal can be discussed and planned. Dr. Banks removes supernumerary teeth in the office setting or the operating room, depending on the difficulty of the procedure.

Some patients have congenitally missing teeth; that is when all the teeth don’t develop. This condition is also called partial agenesis of teeth. Upper lateral incisors and lower second bicuspids are common areas for this condition to occur, but it can occur in any area of the mouth. In some cases, the primary tooth, if present, will be retained until the patient matures and facial bone growth is complete. At this stage, using a Cone Beam CT for guidance, Dr. Banks will coordinate with the dentist and orthodontist and a plan will be formulated to remove the primary tooth and place an implant restoration in the area to replace the tooth.