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The Initial Challenge: A Hidden Tooth and Retained Baby Teeth
The patient first attended our practice following a recommendation from her cousins, who were already undergoing treatment with us. A comprehensive clinical assessment and radiographic review by Orthodontist Claire O’Sullivan revealed several significant developmental hurdles:
- The Impacted Canine: The upper left adult canine (tooth 23) was severely impacted, trapped deep within the roof of the mouth (palatally displaced).
- Retained Baby Teeth: Multiple baby teeth were still firmly retained, blocking the natural pathway for adult teeth to erupt.
- Bite Discrepancy: A Class II molar relationship with moderate crowding across both dental arches.
The Strategic Multidisciplinary Programme
To safely guide the trapped tooth into the dental arch without risking damage to the roots of her front teeth, Dr Claire O’Sullivan design-engineered a precise, multi-stage surgical and orthodontic treatment strategy.
1. Phase One: The Surgical Rescue Mission (Late 2022)
Because the canine was trapped deep beneath the palatal bone, it required an open exposure. Dr Claire O’Sullivan coordinated a specialist referral to our dental surgeon, Dr Stephen Taylor, who comfortably performed a palatal flap surgery under local anaesthetic.
Dr Taylor carefully retracted the palatal tissue, safely removed the overlying bone to expose the hidden crown of the canine, and secured a specialized protective dressing (Coe-Pak dressing) with sutures. A few days later, the dressing was comfortably removed, and an orthodontic bracket was safely bonded directly to the newly exposed canine.
2. Phase Two: Strategic Extractions & Active Traction (2023 – 2024)
Once the canine was exposed, our general dentist, Dr Daniele Ryan, comfortably extracted the retained baby teeth to clear a pathway. Next, fixed metal braces were bonded to both arches.
Our team placed a specialized open coil spring to push the adjacent teeth apart, creating a precise gap. We then initiated active traction—using specialized power chains, custom bracket links, and elastic wear—to gently and gradually pull the adult canine down from the roof of the mouth, out of crossbite, and into its correct position in the dental arch line.
3. Phase Three: Final Realignment & De-Bonding (Late 2024)
Once the canine was successfully brought into the arch, our team focused on perfecting the bite. In late 2024, when our advanced monitoring software (DentalMonitoring) picked up that the protective bite-raising composite on her molars had worn down, our orthodontic therapists promptly adjusted her aligner wire dynamics, moving her into high-rigidity stainless steel wires to settle her final occlusion.
The braces were beautifully de-bonded in January 2025, revealing an exceptionally straight arch wire alignment and a fully corrected, stable bite classification.
Long-Term Result & Maintenance (Late 2025)
To safeguard this magnificent multi-year investment, custom-moulded upper and lower clear Essix retainers were delivered immediately. In April 2025, Ortho Laura Herbsta examined the patient and confirmed stable alignment, noting a natural shade baseline of A1 and completely healthy gum levels.
In October 2025, after the patient accidentally cracked her upper retainer, Dr Claire O’Sullivan acted immediately, taking fresh alginate impressions to manufacture a brand-new upper Essix retainer. To help the patient keep her appliances pristine, the clinic provided her with a premium ultrasonic retainer cleaner. Today, the patient enjoys a fully stable, functional bite and a radiant, confident smile that she can display with absolute pride.
The Specialist Advantage: Moving a tooth from the roof of the mouth into perfect alignment requires an elite team with the advanced training to look beneath the surface. By choosing a multidisciplinary practice like Dublin Orthodontist, this family received a continuous, world-class standard of care—from high-resolution 3D surgical diagnostics to final cosmetic retention polish.
Discover Your Child’s Customised Smile Plan
Is your child missing adult teeth, or has your family dentist mentioned a suspected trapped or impacted tooth? Early specialist evaluation utilizing advanced imaging can save years of complex treatment later in life.
