ORAL AND MAXILLOFACIAL SURGEON in Deer Park, NY
When a permanent tooth refuses to erupt on its own, the path forward is rarely simple, but it is well within the reach of the right care team. Impacted teeth, most commonly canines, can stall an orthodontic treatment plan, compromise neighboring teeth, and affect both function and appearance if left unaddressed. The good news is that surgical exposure, when performed with precision and in close coordination with your orthodontist, can guide those hidden teeth exactly where they need to go.
Dr. Mohamed El-Ounsi brings a depth of training that makes all the difference in complex cases like these. As a Board Certified Oral and Maxillofacial Surgeon, a Fellow of the American Association of Oral and Maxillofacial Surgeons (AAOMS), and a Diplomate of the American Board of Oral and Maxillofacial Surgery (ABOMS), Dr. El-Ounsi completed his residency at NYU Langone and Bellevue Hospital, among the most rigorous OMS training programs in the country. Our oral and maxillofacial surgery services are built around precisely this kind of interdisciplinary, patient-centered approach.
- Experienced Surgeons
- Cutting-Edge Technology
- Collaborative Approach
- Comprehensive Aftercare
- Proven Track Record
What It Means for a Tooth to Be Impacted
An impacted tooth is one that cannot fully emerge through the gum line, either because it lacks sufficient space in the arch, encounters a physical obstruction, or follows an irregular eruption path. While wisdom teeth are most commonly discussed in this context, upper canines are actually the second most frequently impacted teeth, and their position makes them especially important to address.
Canines are the cornerstones of a functional, aesthetic bite. They guide how the upper and lower teeth come together, support lip structure, and anchor the smile. When they fail to erupt, the consequences extend beyond appearance. Adjacent teeth can shift, the bone around the unerupted tooth may deteriorate over time, and orthodontic treatment cannot be completed as planned. According to a 2023 study published in PMC, managing impacted canines through a surgical-orthodontic approach requires early diagnosis, personalized planning, and close collaboration between the surgeon and orthodontist to achieve both functional and aesthetic goals.
ORAL AND MAXILLOFACIAL SURGEON in Deer Park, NY
How Surgical Exposure Works
The goal of surgical exposure is to uncover the impacted tooth, bond an orthodontic bracket to it, and allow traction forces to gradually guide it into the correct position in the arch. The procedure requires careful planning and a detailed understanding of the tooth’s position, angulation, and proximity to surrounding structures, which is why imaging and a coordinated treatment plan are essential before any intervention begins.
Two main techniques are used to expose impacted canines: the open and closed approaches. In the open technique, overlying soft tissue is removed or repositioned to allow the tooth to erupt naturally or with minimal guidance. In the closed technique, a bracket and chain are bonded to the tooth, the flap is sutured back into place, and orthodontic traction begins gradually, with the tooth moving through tissue until it emerges in the proper position. The choice between techniques depends on the tooth’s depth, orientation, and the surrounding anatomy.
Orthodontic Impaction Cases
What the Process Looks Like for Patients
Most surgical exposure procedures are completed in a single appointment, often with the help of sedation to maximize comfort. Here is what patients can generally expect:
- Imaging and planning: Cone beam CT scans and detailed records are reviewed to map the tooth’s exact position and plan the safest surgical approach.
- The surgery: The area is numbed, sedation is administered as appropriate, and the impacted tooth is exposed. A bracket is bonded to the tooth surface, and a small chain is attached for orthodontic use.
- Coordination with your orthodontist: Following the procedure, your orthodontist activates gentle traction forces at scheduled appointments to guide the tooth into position over several months.
- Recovery: Post-operative discomfort is typically mild and well-managed with medication. Most patients return to normal activity quickly.
Treatment timelines vary depending on the severity of impaction, the patient’s age, and the technique used, but outcomes with surgical-orthodontic management are consistently strong when approached collaboratively.
ORAL AND MAXILLOFACIAL SURGEON in Deer Park, NY
Why Timing and Coordination Matter
One of the most important factors in a successful impaction case is timing. Younger patients tend to see faster, more predictable results because bone is more responsive and the tooth has greater potential to move. However, adults are not without options; outcomes remain favorable with proper planning and technique. The critical step is not delaying once impaction is identified.
Equally important is the level of communication between the oral surgeon and the orthodontist.Â
Dr. El-Ounsi works closely with referring orthodontists throughout Long Island, ensuring the surgical component is executed in a way that sets up the orthodontic phase for success. Our team uses state-of-the-art digital imaging to make precise assessments, and we take the time to walk patients and their providers through every aspect of the plan before treatment begins. For patients who need sedation during the procedure, we offer IV sedation and general anesthesia to ensure a calm, comfortable experience from start to finish.
Schedule an Orthodontic Impaction Appointment Today
Impacted teeth are not a problem to wait out. The longer an unerupted tooth remains untreated, the greater the risk to surrounding teeth, bone, and your overall treatment plan. Whether your orthodontist has referred you for a surgical exposure or you have questions about a tooth that never came in, our team is ready to assess your situation with care and precision.
Dr. El-Ounsi’s training as Chief Resident at NYU Langone and Bellevue, combined with his board certifications and his individualized approach to every patient’s care, means you are in highly capable hands. We welcome referrals from orthodontists throughout Long Island and work collaboratively to deliver predictable, excellent outcomes. We accept a wide range of insurance plans, and financing options, including CareCredit, Cherry, Alphaeon, and Proceed, are available to help make treatment accessible. To learn more about Dr. El-Ounsi and our team, or to schedule a consultation, please contact our office today.