What are buried teeth?
We are all born with a finite number of teeth; 20 baby teeth (10 in the upper jaw and 10 in the lower jaw), and 32 adult or permanent teeth. Occasionally in some of us, some teeth get stuck beneath the gums and are not able to fully erupt or emerge; these teeth are known as buried teeth.
Types of buried teeth
Partially buried teeth
As its name suggests, partially buried teeth have erupted halfway while the other half is still stuck beneath the gums.
Fully buried teeth
Fully buried teeth are completely stuck beneath the gums and/ or the bone.
The second most commonly impacted teeth are the maxillary canine; the canines play a very important role in our dental arch, and they enable us to have a strong bite. Therefore, if the maxillary canines are impacted, every effort is made to ensure that they emerge fully.
What is gold chain bonding?
In gold chain bonding, a gold button mesh and chain are used to gently assist in the eruption of the buried teeth out and into the correct position. This process occurs over a period of time and is not immediate.
How does gold chain bonding work?
Both your orthodontist and oral and maxillofacial surgeon will have to work together to help your buried tooth to emerge. The following steps describe the gold chain bonding procedure:
- You begin your procedure with a visit to your orthodontist to have your braces fitted. These braces are placed on your visible teeth but have spaces vacant for your impacted teeth to emerge into.
- Once your braces have been fitted, you are ready for your visit to your oral and maxillofacial surgeon for the second part of your procedure.
- Under anaesthesia (either local, sedation or general), the piece of gum covering your impacted tooth will be cut and lifted to expose the tooth.
- If a baby canine tooth is still present, it will be removed via surgical extraction.
- The gold button will be attached to your impacted tooth using a special glue (composite resin) and the chain is attached to your newly fitted braces or a neighbouring tooth.
- The lifted gum tissue will be sutured back into place.
- After a brief healing period, you will return to your orthodontist where your gold chain will be gently pulled to bring your impacted tooth into position.
- This process will continue slowly and can last for a few months or up to a year.
What are the benefits of gold chain bonding?
The main benefits of gold chain bonding are an improved look and functionality of your teeth and a decreased risk of damage to the roots of neighbouring teeth.
Are there any risks and side effects of gold chain bonding?
Possible complications include;
- Bleeding, swelling, mild discomfort in your jaw, and infection. The bleeding usually stops after a couple of days and swelling will go away after a few days. Antibiotics and painkillers will be prescribed to address any pain or infection.
- There is a chance that the tooth may be fused to the bone which prevents its eruption. This is usually not known until a period of assisted eruption has commenced.
- Gold chain dislodgement may take place when the orthodontic forces required to assist the tooth in its eruption is greater than the strength of the bonding material. In these cases, the oral and maxillofacial surgeon may need to reattach the gold chain back on the tooth.
Frequently Asked Questions
Leaving the buried tooth where it is also means that there is a corresponding missing tooth in the mouth. This may result in a gap which may require further replacement. In certain cases, buried teeth can cause root resorption or the neighbouring teeth during orthodontic treatment and in rare cases can result in cystic formations.
Leave it in and your dentist will monitor it periodically via x-rays. The teeth can be surgically extracted.
Depending on how quickly your body heals, you should be able to resume normal work/ school activities 3-7 days after your procedure
During the procedure, local anesthesia will be administered. In some cases, sedation or general anaesthesia may be indicated which further alleviates the patient’s pain. Postoperatively, painkillers will be prescribed to make your recovery comfortable.
You will still be numb for a few hours after the procedure. This numbness should disappear after a while and you might experience some mild pain which can be managed by pain medication. Soft diet and the use of mouthwash is recommended for a week after the procedure as the area is still tender. Avoid brushing the area for a week or two.