DuPont Circle | Washington, DC
Downtown McLean | Virginia
Surgical Exposure of Impacted Teeth in Washington, DC
Helping impacted teeth move toward their natural position with precise surgical exposure and coordination with your orthodontist
​Surgical exposure of an impacted tooth, sometimes called expose and bond, is a procedure used to uncover a permanent tooth that has become trapped beneath the gum or bone. The procedure is most commonly performed for impacted upper canines, which may need surgical assistance before an orthodontist can guide them into their proper position.
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At Saltman Oral Surgery, we work closely with orthodontists throughout Washington, DC and Northern Virginia to provide precise surgical exposure of impacted teeth using advanced 3D CBCT imaging, modern surgical techniques, and sedation options designed around each patient's needs.
Our role is to safely expose the impacted tooth and, when appropriate, secure an orthodontic attachment. Your orthodontist then uses that attachment to gradually guide the tooth into alignment. Our goal is to provide careful surgical treatment while maintaining close communication with your orthodontic team.
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Saltman Oral Surgery provides surgical exposure of impacted teeth for patients throughout Washington, DC, McLean, Great Falls, Falls Church, Bethesda, Chevy Chase, Rockville, Arlington, Alexandria, and surrounding communities.
What Is Exposure of an Impacted Tooth?
An impacted tooth is a tooth that cannot erupt into its normal position because it is blocked by bone, gum tissue, another tooth, or another obstruction. Wisdom teeth are the most commonly impacted teeth overall. However, upper canine teeth are among the most common non-wisdom teeth that require surgical exposure and orthodontic guidance.​
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During an exposure procedure, Dr. Zach Saltman, the oral surgeon carefully uncovers the impacted tooth beneath the gum and, when necessary, bone. An orthodontic bracket or other attachment may then be bonded to the tooth and connected to a small chain or orthodontic component.
Your orthodontist uses this attachment to apply gentle, controlled forces that gradually guide the tooth into its proper position.​​​​
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Surgical exposure is therefore a coordinated treatment between your oral surgeon and orthodontist. The oral surgeon performs the surgical portion of treatment, while the orthodontist manages the orthodontic movement of the tooth.
Signs You May Have an Impacted Tooth
Many impacted teeth cause no pain and are discovered during a routine dental or orthodontic examination. Others may present with symptoms such as:
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A permanent tooth that has not erupted as expected
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A baby tooth that remains in place longer than expected
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A noticeable gap where a permanent tooth should be
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Swelling or tenderness in the gums or palate
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Crowding or shifting of nearby teeth
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Pain or pressure in the upper jaw
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A tooth developing in an unusual position
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An impacted tooth identified on dental X-rays or 3D imaging
Impacted canines are often identified during childhood or adolescence through routine dental and orthodontic evaluations. Early evaluation allows your dental team to assess the tooth's position and determine the most appropriate treatment approach.
Why Do Teeth Become Impacted?
A tooth may become impacted for several reasons, including:
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Insufficient space within the dental arch
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A retained baby tooth blocking eruption
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An abnormal eruption angle
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Extra (supernumerary) teeth
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Dental cysts or other obstructions
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Dense bone or thick gum tissue
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Developmental or genetic factors​
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The position and development of an impacted tooth can vary significantly from patient to patient. Dental X-rays and 3D CBCT imaging can provide important information about the tooth's location and its relationship to surrounding teeth and structures.
Why Treating an Impacted Tooth Matters
An untreated impacted tooth can sometimes contribute to complications. It may:
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Damage the roots of neighboring teeth
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Lead to cyst formation around the impacted tooth
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Cause crowding or shifting of surrounding teeth
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Affect bite or alignment
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Create gaps in the smile
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Make future orthodontic treatment more complex
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Early evaluation can help your dental and orthodontic team understand the position of the impacted tooth and determine whether surgical exposure and orthodontic guidance are appropriate.
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Although impacted canines are commonly treated during adolescence, adults may also be candidates for treatment depending on the position of the tooth, surrounding anatomy, and overall treatment plan.
What to Expect During Treatment
Consultation and 3D Imaging
Treatment begins with a comprehensive examination and 3D CBCT scan. This imaging allows us to determine the exact position of the impacted tooth in relation to nearby tooth roots, nerves, and surrounding structures. The additional detail provided by CBCT imaging helps guide surgical planning and allows Dr. Saltman to better understand the tooth's anatomy and surgical approach.
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Selecting the Appropriate Surgical Technique
Depending on the position of the tooth and surrounding gum and bone, Dr. Saltman may recommend an open or closed eruption approach.
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Closed Eruption Technique
The gum tissue is gently opened, a bracket and orthodontic chain are attached to the impacted tooth, and the tissue is repositioned over the tooth with only the chain extending through a small opening. This technique is often recommended for teeth located higher within the jaw and may support more natural gum contours after eruption.
Open Eruption Technique
When the tooth is positioned closer to the surface, a small window of gum — and occasionally bone — is removed to expose the crown. The orthodontic attachment is secured directly to the tooth, allowing immediate orthodontic access.
Your oral surgeon and orthodontist will determine which technique is most appropriate based on your individual anatomy and treatment goals.
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The Procedure
Exposure surgery is performed on an outpatient basis and typically takes about an hour, depending on the complexity of the case.
Patients typically receive local anesthesia along with a sedation option such as:
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Nitrous oxide
After the tooth is exposed, an orthodontic bracket and orthodontic chain are attached, allowing orthodontic movement to begin after healing.
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Orthodontic Guidance
Your orthodontist will determine when to begin applying gentle orthodontic forces, typically after the surgical site has healed sufficiently. These forces gradually move the tooth into its proper position over several months to more than a year, depending on the starting location of the tooth.
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Regular orthodontic appointments monitor progress throughout treatment.
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Recovery After Impacted Tooth Exposure Surgery
Some swelling and soreness are expected for several days after surgery, although the amount of discomfort varies from patient to patient.
Discomfort can generally be managed with prescribed or over-the-counter pain medication. Dr. Saltman will provide specific instructions for managing discomfort, protecting the surgical site, and maintaining good oral hygiene during healing to help ensure a smooth recovery.
Recovery typically includes:
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Returning to school or normal activities within one or two days, depending on individual healing
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Eating a soft-food diet for several days
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Keeping the surgical area clean according to your postoperative instructions
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Attending a follow-up visit to monitor healing before orthodontic activation​
Cost and Insurance
Does Insurance Cover Impacted Tooth Exposure?
The cost of surgical exposure varies depending on the position of the tooth, complexity of the procedure, required imaging, anesthesia or sedation, and your individual treatment plan.
​Some dental insurance plans provide coverage for surgical exposure of an impacted tooth, but benefits vary between plans and patients.
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Our team will provide the necessary documentation and insurance claim forms, help you maximize any reimbursement for which you may qualify, and discuss available payment options before treatment begins.
Why Choose an Oral Surgeon for Exposure Surgery?
Exposure of an impacted tooth requires careful surgical planning and close coordination with orthodontic treatment. An oral and maxillofacial surgeon has specialized training in managing impacted teeth, complex facial anatomy, and surgical procedures involving the jaws.​
Why Patients Choose Saltman Oral Surgery
Patients and referring orthodontists choose Saltman Oral Surgery because of our commitment to careful planning, communication, and patient-centered care.
At Saltman Oral Surgery, we offer:
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Advanced 3D CBCT imaging for detailed surgical planning
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Precise surgical techniques designed to preserve surrounding teeth and tissues
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Sedation options for patient comfort
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Close communication with your orthodontist throughout treatment
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Individualized care for children, teens, and adults
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A welcoming environment for anxious patients and families
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Personalized treatment plans designed around each patient's unique needs
Frequently Asked Questions about Impacted Tooth Exposure
Schedule an Impacted Tooth Exposure Consultation
If your dentist or orthodontist has identified an impacted tooth, an oral surgery evaluation can help determine the tooth's position and whether surgical exposure is appropriate.
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At Saltman Oral Surgery, we combine advanced imaging, careful surgical planning, modern sedation options, and close communication with your orthodontist to provide coordinated care for children, teenagers, and adults.
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If you or your child has been referred for impacted canine exposure or expose-and-bond treatment, our team is here to answer your questions and guide you through each step of the process.​​​
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Washington, DC: 202-331-4110
McLean, VA: 703-752-2204
Monday–Friday: 9:00 AM–5:00 PM
You can also contact our team at contact@saltmanoralsurgery.com
For Orthodontic Referrals
Saltman Oral Surgery works closely with orthodontists throughout Washington, DC and Northern Virginia to provide surgical exposure of impacted teeth and coordinated expose-and-bond treatment.
We welcome referrals for impacted canines and other teeth that may require surgical assistance before orthodontic movement. Dr. Saltman uses 3D CBCT imaging and careful surgical planning to evaluate the position of the impacted tooth and coordinate the surgical approach with your orthodontic treatment plan.
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If you are an orthodontist referring a patient for impacted tooth exposure, our team will communicate with your office regarding the surgical plan, timing, and postoperative care.
