Chaining cuspids

[Slipper]

We have known for a while that my oldest daughter's cuspids/canines were not dropping into place as they should. There is plenty of room (thanks to braces) but they aren't descending.

 

Our ortho said that next month they will x-ray and start the prep for chaining but that an oral surgeon would need to do the procedure. Of course, this would be the day that my husband took the girls, so I'm a little unclear on the particulars.

 

Has anyone had this done before with their kids? Any advice? My oldest is autistic and non-verbal so any surgery takes a bit more planning (and a lot more medication).

[Night Elf]

I wonder if you're talking about what my son is going through. His canines are impacted in the roof of his mouth and the baby teeth never fell out. He got braces and part of them was to open spaces for the canines. 8 months after getting his braces, he had oral surgery to extract the baby teeth, expose the impacted teeth and put brackets on them. They attached a chain from the bracket to his braces wire. Then the orthodontist removed the chain but used wire to attach the brackets to the braces so that the now exposed teeth will be pulled into position. It's not an easy fix and his mouth is a little sore with every visit. For a while, he was going every 3 weeks to move that wire, but the last time they didn't do anything and told us to come back in 4 weeks. So it's working but I don't know what the remainder of the process will be like.

[Slipper]

Yes, I think that's the same (or very similar). In my daughter's case I believe they removed the baby teeth and they've been widening the gap where the teeth go, but for some reason they won't drop into place. They're impacted in the roof of her mouth.

 

It doesn't sound pleasant, hopefully it's easier than it sounds?

[TechWife]

My canines never came down, but they were fully exposed. I had braces as an adult and the orthodontist put the chain on at a regular visit. I don't remember it taking very long for them to come down, but I don't remember details at this point.

 

I'd call & ask the office what they are talking about.

[Mommy22alyns]

I'm listening in. The ortho mentioned the possibility of putting chains on one of Rebecca's teeth that erupted out the front of the gum. We had the baby teeth underneath extracted in hopes that it would move down. And then Sylvia went and also had a tooth erupt out of the front of HER gum! Shoot me now!

[VeganCupcake]

I had a canine in the roof of my mouth and had it exposed and attached to my orthodontic stuff when I was a teen. It wasn't the loveliest oral procedure I've ever had, but it wasn't terrible, either. There was a lot of bleeding because my dentist, who did the procedure, did not use a cauterizing tool of some kind. I remember the orthodontist complaining about that when I went to their office immediately after the exposure. I imagine an oral surgeon would have better tools, and likely the procedure has improved as well.

[Tammi K]

Yes, I think that's the same (or very similar). In my daughter's case I believe they removed the baby teeth and they've been widening the gap where the teeth go, but for some reason they won't drop into place. They're impacted in the roof of her mouth.

 

It doesn't sound pleasant, hopefully it's easier than it sounds?

My daughter is in the final stages right now. They just were able to get a bracket on the tooth at her last visit. The process wasn't at all traumatic for her. But, she's a pretty stoic kid and even if something hurts she doesn't complain (wish all my kids were like that. :glare: ...) so I don't know if it 'really' hurt or if she just dealt with it. The surgery itself was fairly quick and she did fine with over the counter pain meds and the chain, then later wire, was no more of an insult to her mouth than the braces were.

 

Hugs to your daughter. It's never fun to have people mucking about in your mouth.

[Mom2TheTeam]

I was an orthodontic assistant for 8 years prior to becoming a SAHM. :)

 

You ladies are describing it pretty well and don't really need me. LOL. But, I'll just add, sometimes the surgeon is able to expose all of the cuspid and attach the bracket and you can see the tooth with the braket on it. Other times, even after surgery, you can't see the tooth or the bracket, just the chain hanging down through the gums. Depending on how impacted it is, it take a few months to pull the tooth down enough to attatch it to the wire. The surgeon usually just attatches the bracket wherever he can get access to the tooth and it isn't the same brand of bracket the ortho uses. So, when it first pops through, the bracket may be in an odd spot and the tooth may be in a bad position and it might look odd. The ortho will change the braket as soon as he has enough tooth to do it and then it will quickly move into position.

 

It sounds invasive and painful, but really it's not that big of a deal. It's pretty gentle for what it is. It is a little scary, but she'll do just fine. :)

[Donna]

My canines never came down. I didn't lose the baby teeth until they were pulled when I got braces at 32. They cut holes in my gums on the outside and attached the chains while I was having my wisdom teeth out which were more impacted than they thought they'd be and the 2 hour surgery took 6 hours. I don't remember anything as I was under conscious sedation.

 

My oldest had a tooth impacted on the roof of his mouth and the oral surgeon cut a hole in the roof of his mouth to attach the chain. He was sedated (and really strange when he woke up) and it didn't take very long for the procedure itself. He had a little pain for that day but then was fine. It only took a couple months for the tooth to be pulled into place and then they repositioned the chain to turn it to the correct spot.

[GailV]

We have a 14yo friend going through this right now. She had the initial surgery a week ago, and has had her first followup visit. I'd never heard of it before -- it's interesting to see all of this discussion about it now!

[nukeswife]

Just make sure they really know they'll be able to come down. They did this with me when I was a teen and the tooth they thought they could pull down wasn't actually fully formed and instead of moving down, pulled all my other teeth up. I then had to go back and have that stuff undone which meant another 6 months in braces than if they had just left it all alone and put a bridge in after my ortho treatments were done.

[Mom2TheTeam]

Just make sure they really know they'll be able to come down. They did this with me when I was a teen and the tooth they thought they could pull down wasn't actually fully formed and instead of moving down, pulled all my other teeth up. I then had to go back and have that stuff undone which meant another 6 months in braces than if they had just left it all alone and put a bridge in after my ortho treatments were done.

 

It sounds like your tooth was fused to the bone and not able to be pulled down. Unfortunately, you usually can't see that on x-ray prior to trying. However, it is VERY rare, especially in a child. I have seen this procedure many, many, many times and I've only see this happen once. The girl it happened to was older than OP's daughter (though still 18-20, so young for it to be issue) and she had other issue contributing, like a cleft palete. The above senerio can happen, but it's really rare. Don't worry. :)

[Slipper]

Thanks for all the replies. Our main concern will be compliance since she doesn't understand due to her autism. I'm wondering if we will need to cut up everything for her to eat (and what happens if she bites into something when she's not supposed to do so) or if she breaks the chain (or pulls on it!).

 

She can't communicate pain so I hate when we have to do things where I don't know if it will hurt or not.

[nukeswife]

It sounds like your tooth was fused to the bone and not able to be pulled down. Unfortunately, you usually can't see that on x-ray prior to trying. However, it is VERY rare, especially in a child. I have seen this procedure many, many, many times and I've only see this happen once. The girl it happened to was older than OP's daughter (though still 18-20, so young for it to be issue) and she had other issue contributing, like a cleft palete. The above senerio can happen, but it's really rare. Don't worry. :)

 

I realized this is rare, but wanted them to be aware of it. My ortho kept telling my parents to "just give it time" so I thought they should be aware that this can happen so if they notice this, make it known or voice your concerns. I was the same age as the OPs daughter when this happened to me, and I had no other issues like the one you mentioned.

[Night Elf]

Thanks for all the replies. Our main concern will be compliance since she doesn't understand due to her autism. I'm wondering if we will need to cut up everything for her to eat (and what happens if she bites into something when she's not supposed to do so) or if she breaks the chain (or pulls on it!).

 

She can't communicate pain so I hate when we have to do things where I don't know if it will hurt or not.

 

 

My son isn't bothered by it. He eats the same as he did before the procedure, with the same restrictions one has with normal braces, i.e. no nuts, popcorn, chewy candy, etc. The chains don't hang down because the point is that they are pulling the teeth into position, there can't be any slack. Unless your dd specifically worries at the brackets, I don't think they'll bother her.

[Slipper]

My son isn't bothered by it. He eats the same as he did before the procedure, with the same restrictions one has with normal braces, i.e. no nuts, popcorn, chewy candy, etc. The chains don't hang down because the point is that they are pulling the teeth into position, there can't be any slack. Unless your dd specifically worries at the brackets, I don't think they'll bother her.

 

Oh good. She typically doesn't mess with the brackets unless something pops lose or a wire goes wrong. Then she chews on the sides of her thumbs (anxious habit). She has mutilated them at times into a bloody mess.

 

On the bright side, once something becomes a habit, she's absolutely beautiful at compliance. We have to brush her teeth for her, but she preens and turns her head from side to side while we do it like she's getting a facial. lol She loves the attention.