A tooth that is partially or completely stuck beneath gum tissue is affected by impaction. While any tooth is susceptible to impaction, wisdom teeth and canine teeth are the most commonly affected. Regardless of impaction, wisdom teeth are generally removed. Since canine teeth are important to the bite and function of the mouth, extra efforts are made to bring it into its proper position. An oral surgeon and an orthodontist work together to treat an impacted canine through an expose and bond procedure.

Reasons a tooth may be affected by impaction include:

  • Dental crowding
  • Lack of teeth
  • Extra teeth
  • Growths or tumors

While impaction does not always have noticeable symptoms, the presence of swollen gums, tenderness, redness, or draining in the area around the tooth may be a sign of impaction. Your dentist or orthodontist are often the first to recognize an impacted tooth and can refer you to an oral surgeon for treatment. X-ray or 3D imaging can confirm an impacted tooth.

Exposure and Bonding

Treating an impacted canine requires time but is a very successful treatment. First, an orthodontist will prepare the mouth with braces to shift the teeth into their new positions and create a space for the impacted tooth to come in. Next, an oral surgeon will surgically expose the tooth and bond an orthodontic bracket with a small chain to it. This chain will be used by the orthodontist to guide the tooth into the dental arch as it grows in.

During the surgery, patients are kept comfortable with anesthesia. The type of anesthesia selected will be discussed and decided during the consultation. Oral surgeons receive specialized training to be able to administer anesthesia safely.

Types of Anesthesia

Whitewater Oral Surgery Group uses three main types of anesthesia:


Local anesthesia is administered directly to the surgical site and only affects the local area. It is commonly used for minor procedures, such as simple dental extractions or small soft tissue biopsies.

Nitrous Oxide

Nitrous oxide is also known as laughing gas and is a mild sedative inhaled through a mask over the mouth and nose. It is often used in conjunction with local anesthesia. The effects of the gas will dissipate after breathing some oxygen for a few minutes after the procedure.

IV Sedation

IV sedation is administered into the patient’s vein. This type of sedation is most commonly used during impacted wisdom teeth extraction, extensive dental implant surgery, or any surgical procedure that may be more complex in nature.