Definition & Overview
Dental uncovery, also referred to as tooth uncovery, is a dental procedure performed when the tooth develops in the wrong position and fails to erupt normally into the mouth. In this procedure, the tooth is "uncovered" or exposed to allow it to grow out of the gums.
There are cases when the tooth does not come out through the gums and is stuck in an abnormal position, a condition called impacted teeth. These can be due to:
- Improper sequence of tooth eruption - Teeth that have previously erupted could prevent new teeth from growing in their correct position
- Genetic factor or heredity - Impacted tooth, according to studies, tend to run in families
- Teeth crowding - Crowding of teeth can potentially block new teeth from growing, leading to growth in incorrect position
- Excess gum tissue and bone - Thick gum tissue can prevent teeth from properly erupting
- Crossbite - When the position of the teeth and/or the jaw bone is incorrect
- Ankylosis - A condition in which the tooth root abnormally fuses with the bone (in normal conditions, a periodontal ligament is present between the tooth root and the underlying bone)
Who Should Undergo and Expected Results
Tooth uncovery is a procedure performed by dental surgeons in patients who have impacted tooth. Teeth fail to erupt in their proper position due to resistance factors, including thick gums, hard bone, and entrapment with other teeth structures. Uncovery is recommended to eliminate pain and restore normal positioning and functioning of teeth.
In dental uncovery, the surgeon finds a solution to resistance factors in such a way that the tooth is uncovered without damage. In the procedure, the tooth is exposed from underneath the gum tissue. Once accessible, the dental surgeons may attach or activate orthodontic appliances for the tooth to grow normally. Orthodontic treatment for the restoration of tooth position can take about 2 to 3 years to complete. In some cases, the tooth may need to be extracted after uncovery.
How is the Procedure Performed?
Before the procedure is recommended, periodontal exams are first performed to evaluate the position of the tooth and determine the need for uncovery. Once the position is determined, the procedure is planned and scheduled.
Before tooth uncovery is performed, the patient is administered with topical anaesthesia or sedated with laughing gas. In some cases, a general anaesthetic is applied to ensure maximum comfort.
For lip or cheek side tooth impactions (when the tooth is stuck to the lip or cheek), dental surgeons reposition keratinized gum tissue to expose the tooth. For impaction on the palatal side (roof of the mouth), extra bone and gum (and other resistance factors) are removed to allow the tooth to erupt. Once uncovered, dental surgeons usually place any of the three dental appliances listed below to ensure the tooth grows in position. These options are discussed prior to the procedure.
Bracket and chain - A bracket is glued in place to the newly exposed tooth and is connected to a small chain secured to the gum or one of the nearby teeth. This builds pressure on the tooth to restore its natural alignment with the rest of the teeth.
Brace or cover plate - A small, removable brace may be made to prevent the gum from growing again over the tooth.
Gauze pack - A dressing may need to be stitched onto the gum for 7 to 10 days to ensure the wound (stitched in dissolving threads) closes and heals properly.
After surgery, patients usually feel a certain degree of soreness and pain for a few days, as such painkillers are usually recommended. A small amount of bleeding may persist within a day or two. Soft diet and rest are usually recommended for a couple of days, and physical activity and strenuous exercise are highly discouraged. Stitches usually dissolve within 2 to 4 weeks.
Upon discharge, patients are given instructions on proper oral hygiene and cleaning the dental appliances attached, which will be done a day or two after surgery. These include mouth rinsing with warm salt water or an appropriate chlorhexidine mouthwash. It is imperative that the mouth is kept clean to prevent infection from occurring.
Possible Risks and Complications
- Tooth uncovery is a safe procedure but is still essentially a minor surgical procedure. As such, there might be some risks and side effects, which may include:
- Bleeding within the first 24 hours - A common occurrence and should not be a cause for alarm
- Pain within the next few days – This can be controlled with over-the-counter pain medications
- Infection - A rare complication that can be treated with antibiotics
Anaesthetic risks - Also a rare complication that accompanies any procedure with anaesthetics involved
American Association of Oral and Maxillofacial Surgeons.