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Gold chain bonding for buried and impacted teeth

Tooth development and growth varies hugely from one person to another. The majority of people develop all their adult teeth however a small percentage have a tooth that can become impacted and stuck in the jaw bone. The most commonly buried is the wisdom teeth but often these teeth remain impacted under the gum and within the bone and do not require removal.

Types of impacted or buried teeth

  • Partially buried teeth

Partially erupted teeth erupt halfway, and the other half remains stuck under the gums.

  • Fully buried teeth

The teeth are completely stuck under the gums and the bone.

The maxillary canine is the second most commonly impacted tooth. The canines are vital in the dental arch because they allow having a strong bite. If the maxillary canines are impacted, ensuring that they fully emerge is important.

What is gold chain bonding?

In gold chain bonding, the oral surgeon will uncover the buried tooth and place a gold chain on the surface of the tooth. The gums are then put back into position with dissolvable stitches and the chain comes through the gum and attaches to a brace. The orthodontist will then apply gentle traction to the gold chain to gently help the buried teeth fully emerge into the correct position. This orthodontic process can be very lengthy, often taking 2-3 years with braces in place.

How does it work?

The oral and maxillofacial surgeon and orthodontist will work together to help the buried teeth fully erupt. The gold chain bonding procedure involves the following steps.

  • The first step is visiting your orthodontist to establish whether the tooth that is impacted and buried is amenable to orthodontic movement.
  • The surgeon will administer anaesthesia (general, local or sedation), then cut the small piece of gum covering the impacted tooth and lift it to expose it.
  • If you still have your baby canine tooth, the surgeon will surgically extract it.
  • The next step is attaching the gold chain to the impacted tooth with composite resin and attaching the chain to the braces or the adjacent tooth.
  • The surgeon will suture the lifted gum into place with dissolvable stitches.
  • After healing, you will visit the orthodontist to gently pull the gold chain to bring the buried tooth into position.
  • This process occurs slowly and can last for a few years

Benefits of gold chain bonding

The primary benefit of gold chain bonding is improving the functionality and look of the teeth and a reduced risk of damage to the neighbouring teeth.

What are the side effects and risks of gold chain bonding?

The possible complications of gold chain bonding include the following:

  • Swelling, infection, mild discomfort and bleeding. The bleeding often stops after a few days, including the swelling. The oral surgeon may prescribe painkillers and antibiotics for the pain or infection.
  • The is a possibility that the tooth is fused to the bone preventing its eruption. This may not be known until the assisted eruption gets started. If the tooth is fused to the bone then it will need to be removed and a replacement tooth such as an implant will be discussed.
  • The gold chain may get dislodged when the orthodontic forces needed to assist the tooth’s eruption are more than the strength of the bonding material. In this case, the surgeon may reattach the gold chain to the tooth.

If you have a partially or fully buried tooth, visit Kingston Orthodontics to start your gold chain bonding procedure. You can contact us at 0203 002 2501 to book an appointment with our orthodontist.

Frequently asked questions

Leaving your buried tooth in its position means you will have a missing tooth in that space. This gap may need further replacement. In some cases, a buried tooth can cause root resorption or damage to the neighbouring teeth during the orthodontic treatment. In a few cases, cystic formations may occur.

The alternative is leaving the buried tooth in, and the dentist will perform X-rays periodically to monitor it. A surgical extraction may be necessary.

You should resume normal school activities or work in 3 – 7 days after the procedure, depending on how fast your body heals.

During gold chain bonding, you will be given anaesthesia. This may be general anaesthesia or local anaethesia to prevent pain. The doctor will prescribe painkillers to ensure your recovery is comfortable.

You will be numb for a few hours following the procedure. The numbness should subside after a while, and then you may experience some mild pain which pain medication can manage. Your doctor will recommend a soft diet or mouthwash for a week after the procedure because the area will remain numb. Avoid contact sport or swimming for 7-10 days after the surgery.


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