Fully impacted canine extraction plus 3-4 other extractions

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#1 Post by **Lin** » Tue Jan 17, 2006 3:33 pm

Hi everybody... let me introduce myself:

I'm a 25-year-old female with crooked teeth/bad crowding, a slight overbite, and a fully impacted/unerupted right top canine... and I finally decided I have had enough of it. I have put off getting braces for over ten years because of fears of the oral surgery required to fix all the drama in my small mouth. I had all 4 impacted wisdom teeth removed when I was 17, and my individual experience with that was such that, at that age, I could never have seen myself doing what I am about to have done.

My new orthodontist told me that I will need to get braces on first - ceramic on top, metal on bottom, and wear these for about 4 months before the oral surgery. At that time, two premolars will be extracted from the bottom, my top right baby canine will be pulled, and there may need to be another normal tooth extraction up there due to crowding.

But the thing I am really concerned about is the impacted canine removal that will also happen during the surgery. My oral surgeon said that he will have to cut through the hard palate bone in the roof of my mouth then dig around for the impacted canine, section it, and remove it, then stitch it all back up. The bone supposedly takes 4 months or so to grow back.

Has anybody else had this procedure done - a fully impacted top canine removed from the back of the teeth / roof of the mouth, going through the hard palate bone? I would like to know about your experience with this, as I tend to think all of this will be much worse than my wisdom extraction was. I will have general anaesthesia for the surgery because when it comes to such procedures, I am very nervous and don't really want to witness potential sounds/pressure/discomfort. This will be interesting in itself because I have a phobia of anaesthesia.

My braces and elastics should take about 27 months, and I am supposed to get separators next Wednesday, then the braces on the Tuesday after. I have no idea what to expect except a lot of pain and discomfort for the next 2+ years. Am I out of my mind to do this, or will I really thank myself for it when I'm older and it's done with?

I'd appreciate any thoughts or comments. Thanks!

#2 Post by **missing_tooth** » Wed Jan 18, 2006 1:57 am

I may have to have this done. It's called bone grafting. Like you I find the idea of being put under a bit scary. Although I have done it once before. Of course at first they are going to try and bring the tooth down first.

#3 Post by **fyrelight** » Wed Jan 18, 2006 7:13 am

NO, I had both my impacted canines EXPOSED in the palate..... instead of removed.... and yeah, I remember I was sore for a few weeks, but I don't remember it being all that bad. Of course, less bone is removed to just expose a bit of tooth to put a bracket on it, than if you are getting the whole long tooth exposed and removed... canines are LONG! They can't bring your canine into position??? It might be less traumatic!

#4 Post by **Lin** » Wed Jan 18, 2006 5:54 pm

Missing_tooth, isn't it only bone grafting if they put bone in to reconstruct an area? As I understood the way my oral surgeon described it, he would just cut through my bone and it would all have to grow back? Or maybe he cuts some out and puts it back? I am not sure. I would like to know... would also like to know how much bone will be lost. My oral surgeon didn't seem very willing to talk in great length.

And thanks for the well-wishes, Meryaten

Fyrelight, how long did it take for them to pull your canines down after they were exposed? My ortho and oral surgeon said it was an option, but my ortho said that he thought it would be much more painstaking/painful since it would take about 8 months to wire down and it would have to be tugged on and left quite sore every few weeks. "If you were my sister," he said, "I'd say go with the extraction instead." Eek! None of it sounds terribly pleasant.

#5 Post by **fyrelight** » Wed Jan 18, 2006 6:03 pm

There's actually a thread on another board that discusses everyone's experiences. Mine took maybe a year and 6 months. My deal was, I had enough room for it, and I didn't want to damage the surrounding teeth to get a bridge, nor did I want to get an implant, so yeah, I went for it.

#6 Post by **Lin** » Wed Jan 18, 2006 6:25 pm

I'll check out that board... thanks!

#7 Post by **joplin** » Thu Jan 19, 2006 9:32 am

Lin, I had both my impacted canines surgically removed, but mine were removed from the "lip side", not the palate side. My surgery report is here (and some more on the following page): viewtopic.php?t=444&postdays=0&postorder=asc&start=120

#8 Post by **joplin** » Thu Jan 19, 2006 9:32 am

Double post, sorry!

#9 Post by **Lin** » Thu Jan 19, 2006 2:51 pm

Joplin, thank you for sharing your story! Did they know before your surgery that they could go in the "lip side"? I think that I have other tooth roots in the way on that side, but who knows.

I guess I'll start my own little story topic and try to settle in for the long journey ahead.

#10 Post by **joplin** » Fri Jan 20, 2006 4:32 am

Did they know before your surgery that they could go in the "lip side"?

Yes, I had a lot of x-ray work done beforehand to make sure where exactly those teeth were hiding and where the roots of the adjacent teeth were. Good thing I did, because at first the surgeon and my ortho both were pretty sure those canines would be on the palate side, where they in most cases are (or so they said). For me as a patient it was a lot easier procedure to have them extracted from the "front".
Are you going to have x-rays taken first? I think it would be a good idea.

#11 Post by **fyrelight** » Fri Jan 20, 2006 7:41 am

Yeah, they had to take several x-rays of mine to make sure where mine were located... when they're going hunting for them, you don't want them just digging around, ya know?

They found mine were in the palate, but were aimed downward toward the right area, and were just in a "great location" to bring down. Plus, they weren't ankylosed, so it was just the best choice for me.

Tue Jan 24, 2006 12:33 pm

Lin, I am in the process of having an impacted canine brought down from the palate. I had the surgery to expose it last October. I had a terrific sinus headache for 6 days, but I would say the worst part for me was the raw skin around the tooth. He drilled the bone around the tooth to expose it and left it all raw. It is impossible to eat without disturbing the roof of your mouth. I was able to eat most stuff after about 2 weeks, and after about 3 the skin was healed. I don't think he had the option of closing it because the tooth was too close to the surface.

Hopefully if they close you back up, healing will be faster.

I chose to try to have the tooth brought down to where it belongs because I need that tooth and thought having my own is better than an implant. I had spaces instead of crowding.

I would advise you to make sure you are confident in your Oral Surgeon and that he has done all the x-rays he needs. If not, get another opinion. They took an x-ray of mine straight down from the top if my head to help figure out the position.

Good luck. And oh by the way......as bad as I thought this was, it wasn't nearly as bad as having my wisdom teeth out, and memories of THAT experience should have waned some in the 33 years since I had it done, but I still remember it as worse. Hope that helps.

#13 Post by **Lin** » Tue Jan 24, 2006 1:33 pm

Hi all... I had one x-ray taken (panoramic?) of the entirety of my mouth at my first ortho consult... But they didn't do any other x-rays, like a top-down shot, or anything else.

You have all definitely inspired me to press that issue, however. It could be that my ortho will have new x-rays taken right before the surgery 4 months or so from now, as I assume the braces will have moved my teeth enough by then to warrant it. However I am not sure of that. I am going to ask and ask again.

Pam, how much bone was drilled through in the roof of your mouth? I know it will be more for me since they will actually have to extract the tooth, but I am hoping it isn't too big. I would like to see a top-down x-ray to know where my tooth is, you would think they would have done that for me by default.

And yes, what you mentioned to me does help very much indeed... if it isn't worse than getting my wisdoms out, I just might survive this! Apparently there are fewer nerve endings on the roof of the mouth, so maybe the pain isn't as acute as in the gums... that is what the oral surgeon's assistant told me.

I was not completely impressed by the oral surgeon I saw, who was recommended to me by my ortho. I was very nervous, so maybe he was reacting to my own vibe, but he didn't seem like he had a whole lot to say about it all.. didn't really offer to explain the procedure in detail or anything like that. I might see if there are any other folks available, but it seems like this is the biggest (only?) place in town to do this. I keep thinking... well maybe his surgical knowledge and abilities compensate for his lack of charisma and questionable interpersonal demeanor (that being, not terribly open or likeable).

#14 Post by **fyrelight** » Tue Jan 24, 2006 10:16 pm

Lin, I'm not sure there's a way to measure how much bone was removed.... but it can't have been all that much. The idea in exposure is to expose a little bit of the tooth, just enough to put a bracket on. In my case, they cut a slit behind my front teeth, canine to canine, and kind of "peeled back" the roof of my mouth. At that point, they found the teeth and drilled/sawed around the tooth to get enough surface to attach a bracket to. They glued the bracket on, then sewed the roof of my mouth back to behind my teeth. All that was left to do then was to tie the gold chains that were attached to the brackets down to my archwire, and I was done. Worst part, honestly, was the SHOTS in the roof of the mouth... that is SUCH a tender area and shots there hurt me so much more than any other ones ever do. And the lidocaine kept wearing off, so they kept having to shoot me more times.

Anyhow, that was my experience....

Wed Jan 25, 2006 11:27 am

From another Pam..

Lin, I'm not sure how much bone was covering the tooth, but when he was finished, the surface of my tooth that is laying horizontal was exposed and then he had drilled around the tooth like the width of the drill bit. All in all I had a hole about the size of a dime. But I think the exposure depends on the way the tooth is lying and how much he needs to expose to make sure the tooth isn't ankylosed, or free to it up, I don't know. My tooth was very close to the surface, so instead of going deep then closing back up, they took more surface area and left it open. He did put a glob of putty type stuff in the hole which he called a band aid. That helped a lot, until about the fourth day when the swelling went down and the putty started causing its own problems, moving around and further irritating the skin. I think I would have been better off I would have known that was what was causing the pain instead of the exposure itself. After I removed the putty, I felt better. (He had said that it should stay in for seven days but if it fell out it would be ok. So I thought being there would be best, but I was wrong)

I don't remember him putting injections into my palate, but he put them into my gum just like when having a filling. Maybe he put injections into my palate after I was numb. One thing I thought was weird is that when I have fillings or crowns, I will be numb for the rest of the day, but with this canine exposure the feeling returned before I even got home. At that time, I sure was wishing it was still numb. Anyway, if you are asleep during the procedure the injections if any shouldn't bother you. I chose to stay awake during the procedure just so I could drive home. That was a little stupid of me.

Wisdom teeth removal was still worse. I don't know why, but I'm a big baby about oral surgery. I'd rather have abdominal surgery (which I have had). I still have to have one implant and a frenectomy. I'm dreading it, because now I don't really believe them when they tell me its no big deal. With the canine exposure they told me I would go back to work the next dayl....wrong. I had it done on Wed., stayed home on Thursday, went to work on Friday but was worthless. Monday when I returned, I was better but not strong because eating was almost impossible.