hey it's dr amanda with straight smile solutions street smile solutions.com and today we're going
to tackle the subject of impacted canines from a slightly different direction i have a lot of other
videos about impactive canines how to do exposing bond how to select cases for exposing bond
this so if you want to listen to those you'll want to go into my channel and just look up impacted
canine or canine and all those videos should show up today we're going to take it from a different
direction we're going to talk about can we not do the exposing bond can we leave the impacted canine
so impacted canines are pretty common um i have a daughter who has one and as far as i know we never
had had him in our family so she has a hard one too um but you know it's for the most part genetic
but it also could be related to um inadequate expansion arch development as a kid habits and
other things um in her situation it definitely wasn't related to the latter so it must have
been genetic i blame it on my husband but in any case hopefully he doesn't listen to this video um
can we leave them so i get this question all the time you know you're taking a panel and sometimes
the patient has no idea they even have it right maybe they have the baby tooth that's still there
and they just thought that was the canine all this time and sometimes they know and they're
like hey i want a liners i want to visualize i want straighten my teeth can i just leave it
so my answer to this is you as the general pediatric dentist or even the orthodontist
shouldn't answer that question i always punt that question if if i think it's even possible if it's
if it's a no it's a no like in this situation like this and this no you can't leave it why
because we're going to be moving around the other teeth then we're going to run into that tooth and
we're going to damage those teeth and even if you attempt it even if you had every disclaimer
in the world signed and i've i've even tried this before that's how i know this you know
you know if and when there was damage down the road that happened or external resorption that
happened later down the road you'll be liable you will be liable for saying it was okay
so my answer was always no my answer is either it comes out or we do it expose and bond
now what if it's high and dry up like this i'm looking at this i'm like it's probably
fine to go ahead and do it but guess what i'm not making that call i am going to let the expert the
specialist in this topic make that decision so whether you're sending it to a dental radiologist
to re to interpret the cbct not a pan but a cbct or you're sending it to an os to interpret the the
cbct i specifically like to ask in the referral slip patient is interested in orthodontics
invisalign whatever is it okay please take cvt and interpret and um and and let us know if
it's okay to leave tooth number 11 you know or 6 and 11 impacted um while we commence orthodontic
treatment something like that and then they'll reply back yes there is no chance of resorption
there's no pathology it's okay to leave it so it's important that you get that in writing back
because if when you were to do treatment say in a case like this or even a case that's a little bit
maybe a little more iffy if later down the road there was reabsorption or damage to
the healthy teeth you would be liable if you didn't have that release okay
so that way it puts the responsibility on the interpreting dentist to make that call so just fyi
and of course you want to have your informed consent done there is a section on this kind
of stuff in most informed consents but make sure it's there but you would maybe want to have a more
robust one you know you can create your own um things like that but yeah if it's erupted
and anywhere near the roots that i can tell of the teeth i'm gonna be moving it's a big fat no
nope no way not happening you know unless you've taken that cbct and you know it's so palatable
that there's no way the roots are gonna hit it you know what i mean so let the interpreting
doctor read it and respond and make that decision do not let patients push you around because it's
so common that patients do this um where they're like oh it'll be fine i don't care well you are
going to care if all your front teeth fall out because we damaged them right you will care
you know five years down the road 10 years down the road so we need to make sure we're first doing
no harm and if we know better we can't be pushed around to do things all right thanks so much