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Expose and Bond for Stronger Teeth

By Dr. Andrew C. Aiken

Oral surgeons are often called upon to make sure canines grow in properly.

There are some basic pitfalls when it comes to dental development. The infamous third molars, for example – a.k.a. wisdom teeth – are well known for becoming impacted instead of growing out properly, causing the (sometimes urgent) need for their extraction.

Impacted Canines

Less well known, but still very common, is the problem of impacted upper canines. And we have a three-word solution to this condition: expose and bond.

Also known as the maxillary cuspid or “eyetooth,” upper canines are the second-most likely to become impacted after wisdom teeth. But while wisdom teeth have little function and can be removed without loss – making extraction the obvious procedure if they become impacted – upper canines are important for everyday chewing and play a big role in guiding a person’s bite, closing down like a lid over the lower jaw.

For this reason, they should be spared whenever possible, and their growth and development watched closely from around age seven onward.

Should it be found that the canines are developing poorly, an initial treatment may involve braces to make room for them to “erupt” – emerge from the gums – and grow into place. But if that still doesn’t happen, it’s likely an oral surgery will be needed to perform the “expose and bond” procedure in conjunction with the orthodontist’s aid.

The Expose & Bond Procedure

The procedure is simple enough, with the gum over the impacted tooth or teeth lifted back to expose the canine beneath. Then a bracket to the errant canine is added. After a few days, the patient returns to the orthodontist, who now has a means of clasping the canine and applying a light downward pull to bring it in line.

This process is slow and steady, and it can take a year or so before the canines fully grow out to their proper place in the dental arch. But patience pays off – and thanks to the expert teamwork, the mouth develops a perfect set of choppers that should last a lifetime.