Impacted Tooth Extraction in Beaverton
Impacted Tooth Extraction is a specialized dental service provided by the board-certified specialists at Aloha Dental Specialty Center in Beaverton, OR. Surgical extraction of impacted canines, supernumerary teeth, and other ectopic teeth that fail to erupt into their normal position.
When a Tooth Is Trapped in Bone and Cannot Erupt on Its Own
Impacted teeth are teeth that have failed to erupt into their expected position in the dental arch due to physical obstruction from adjacent teeth, dense overlying bone, or abnormal developmental positioning. While wisdom teeth are the most commonly impacted, this page addresses the broader category of non-wisdom-tooth impactions: impacted permanent canines, supernumerary (extra) teeth that block normal eruption, ectopic premolars, and other teeth that have deviated from their intended eruption path. These impactions present unique clinical challenges because unlike wisdom teeth, which are routinely removed, many of these teeth have strategic importance in the dental arch and require a decision between surgical extraction and orthodontic-surgical collaboration to guide the tooth into position. At Aloha Dental Specialty Center, Dr. Ostovar evaluates each impacted tooth with CBCT three-dimensional imaging to determine the best approach — whether that is extraction, surgical exposure with orthodontic bracket placement, or monitoring.
Impacted maxillary canines are the second most commonly impacted teeth after wisdom teeth, occurring in approximately 2% of the population. The permanent upper canine has the longest and most tortuous eruption path of any tooth, traveling from high in the maxilla near the orbital floor down to the alveolar ridge. When this path is obstructed — often by a retained primary canine, a supernumerary tooth (mesiodens), or insufficient arch space — the canine becomes impacted, either palatally or labially. Because the canine is functionally critical for occlusion and aesthetically important in the smile, extraction is typically the last resort. The preferred approach is surgical exposure: Dr. Ostovar uncovers the impacted tooth by reflecting a flap, removing any overlying bone, bonding an orthodontic bracket and gold chain to the exposed crown, and then repositioning the flap. The orthodontist then applies gentle traction over months to guide the tooth into the arch. This collaborative procedure requires precise surgical access that preserves the enamel surface, avoids damaging the tooth’s follicle, and positions the bracket in a location that allows the orthodontist to direct eruption bestly.
When extraction is the appropriate choice — as with supernumerary teeth, severely malpositioned ectopic teeth, or impacted teeth that have developed cystic pathology — the surgical approach depends on the tooth’s depth, angulation, and relationship to surrounding structures. CBCT imaging reveals the three-dimensional position of the impacted tooth relative to adjacent tooth roots, the nasal floor, the maxillary sinus, and neurovascular structures. Dr. Ostovar uses this imaging to plan the smallest possible surgical access, section the tooth when needed to minimize bone removal, and manage the surgical site to promote best healing. For children and adolescents, these procedures are often performed under IV sedation to ensure comfort and cooperation during what can be a technically demanding operation.
Serving Beaverton, Aloha, Hillsboro & Washington County
Aloha Dental Specialty Center is located at 18455 SW Alexander St, Suite A, in Beaverton, Or 97003egon. We serve patients from across the Tualatin Valley and greater Portland metro, including Aloha, Hillsboro, Tigard, Lake Oswego, and Tualatin. Our Beaverton office is a 5-minute drive from Aloha, 10 minutes from Hillsboro, and 15 minutes from Tigard via SW 185th Avenue.
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Intel Campuses (Ronler Acres & Jones Farm)
10 to 15 minutes via NW 185th Ave. We accommodate the schedules of tech professionals who need efficient, high-quality specialty care.
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Nike World Headquarters
About 8 minutes via SW Baseline Rd. We frequently see patients from the Nike campus for surgical and implant procedures with sedation options.
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Streets of Tanasbourne & Orenco Station
Easily accessible via US-26 and NW 185th. Local general dentists in these communities regularly refer patients to us for specialty procedures.
Why Local Dentists Refer to Us
We work as a trusted partner to general dentists throughout the Tualatin Valley. When cases require CBCT-guided planning, IV sedation, bone grafting, or other advanced procedures, local providers refer to Dr. Ostovar for his fellowship-trained expertise and predictable results.
We handle the complex surgical phases and coordinate closely with your general dentist for smooth continuity of care from start to finish.
Understanding Your Investment
At Aloha Dental Specialty Center, we provide transparent pricing before any treatment begins. The cost of your procedure depends on clinical complexity, materials used, and sedation requirements. We walk you through every line item during your consultation so there are no surprises.
What Affects Cost:
- Clinical Complexity: Bone loss, sinus proximity, nerve involvement, or the need for grafting affects treatment planning and surgical time.
- Materials: We use research-backed implant systems, purified bone graft matrices, and high-strength ceramics from established manufacturers.
- Sedation: Options range from local anesthesia to IV sedation, each with different associated costs. We discuss the best option for your comfort and procedure.
Insurance & Financing
We accept most major dental insurance plans and file claims on your behalf. Our team verifies your benefits before treatment and submits pre-treatment estimates with clinical documentation to maximize coverage.
For out-of-pocket costs, we partner with CareCredit and Cherry for flexible payment plans. We also offer our ADSC Dental Savings Plan for patients without insurance.
Recovery After Impacted Tooth Surgery
Recovery depends on whether the impacted tooth was extracted or surgically exposed for orthodontic guidance. Both involve a healing period that we manage closely.
First 48 Hours
Moderate swelling and discomfort are expected, especially if bone was removed to access the impacted tooth. Apply ice packs in 20-minute intervals. Take prescribed pain medication on schedule. Eat soft, cool foods. If an orthodontic bracket was placed, avoid pulling on the attached chain. Keep the surgical area clean with gentle rinses only after the first 24 hours.
Days 3 to 7
Swelling peaks around day three and then subsides steadily. Sutures begin dissolving. For exposure cases, the orthodontist may begin applying light traction to the chain within one to two weeks. For extractions, the socket fills with granulation tissue. Transition to soft foods as comfort improves. Most patients return to school or work by day three to five.
Long-Term Healing
Soft tissue heals within two to three weeks. For extraction sites, bone fills in over three to six months. For exposure and orthodontic traction cases, the tooth may take six to eighteen months to fully erupt into the arch under orthodontic guidance. Follow-up appointments monitor healing and, for exposure cases, confirm the bracket remains bonded and the tooth is responding to traction.
Questions during recovery? Call us at (503) 822-0096. We are available for post-operative concerns.
The Developmental Biology of Tooth Impaction
Tooth eruption is an extraordinarily complex biological process that requires the coordinated interaction of the dental follicle, the reduced enamel epithelium, osteoclasts that resorb bone along the eruption path, and osteoblasts that deposit bone behind the developing root. When any element of this process is disrupted, impaction results. The maxillary canine is particularly vulnerable because its eruption path is the longest of any tooth — originating near the floor of the orbit and traversing laterally and inferiorly through the maxilla over a period of several years. During this journey, the canine’s path is guided partly by the root of the lateral incisor. If the lateral incisor is congenitally missing, has a peg-shaped root, or is displaced, the canine loses its guidance and frequently deviates palatally. Supernumerary teeth, particularly the mesiodens (an extra tooth in the midline), create a physical barrier that blocks the eruption of permanent incisors. The dental follicle surrounding an impacted tooth retains the ability to form a dentigerous cyst through fluid accumulation between the reduced enamel epithelium and the crown, which is why impacted teeth must be monitored radiographically even when asymptomatic. The decision to expose and orthodontically guide an impacted tooth versus extract it depends on the tooth’s position, the degree of root development, the presence of ankylosis (fusion of root to bone), and the patient’s age and orthodontic treatment plan.
Why Choose a Specialist?
Impacted tooth surgery demands three-dimensional diagnostic capability and the surgical judgment to tailor the approach to each tooth’s unique position. A palatally impacted canine requires a different flap design, different bracket placement angle, and different bone management than a labially impacted canine. An impacted supernumerary tooth sitting between the roots of permanent incisors requires extraction without damaging those roots — a task that is essentially impossible without CBCT-guided planning. Dr. Ostovar works directly with orthodontists across the Portland metro area on impacted canine cases, coordinating the surgical exposure, bracket positioning, and chain direction to optimize the orthodontic eruption vector. This surgeon-orthodontist collaboration is the standard of care for impacted canine management and is one of the most common reasons orthodontists refer patients to our practice. For impacted teeth requiring extraction, Dr. Ostovar’s fifteen-plus years of surgical experience and fellowship training ensure that adjacent teeth, nerves, and the maxillary sinus are protected throughout the procedure.
Your Impacted Tooth Extraction Treatment Steps
- Consultation & Exam: Comprehensive impacted tooth extraction evaluation with CBCT 3D imaging at our Beaverton office.
- Treatment Plan: Board-certified specialist discusses your impacted tooth extraction options, timeline, and costs. Our procedures maintain a 95%+ success rate, backed by advanced 3D imaging and evidence-based protocols.
- Treatment: Procedure performed with comfort options including sedation if needed.
- Follow-Up: Post-treatment monitoring and care coordination for best healing.
Schedule Your Appointment Today
Book a consultation with our board-certified specialists at Aloha Dental Specialty Center in Beaverton, OR. Call (503) 822-0096 Office hours: Monday through Friday 7 AM to 7 PM, Saturday and Sunday 8 AM to 2 PM. or request an appointment online.
Related Services at Aloha Dental Specialty Center:
Dental Implants · Oral Surgery · Root Canal · Invisalign · Periodontics · Pediatric · TMJ Treatment · Sedation · Cosmetic · Emergency · Sleep Apnea
From Dr. Ostovar: What Patients Should Know
“I know oral surgery sounds intimidating — many patients tell me they’ve been putting this off for months or even years. Here’s what I want you to know: with IV sedation, you won’t remember anything. You’ll close your eyes, and the next thing you know, it’s done. Most patients say the anticipation was far worse than the reality.
Recovery depends on the complexity. For a straightforward case, you’re looking at 2-3 days of swelling managed with ice packs and ibuprofen, then gradual improvement over the following week. I recommend soft foods for 7-10 days — yogurt, scrambled eggs, mashed potatoes, smoothies. No straws, no smoking, no vigorous rinsing for at least 5 days.
I always use CBCT 3D imaging before any surgical procedure. A standard X-ray gives me a flat picture — the CT scan shows me exactly where the nerves are, what the bone looks like in three dimensions, and how to plan the safest approach. It makes a real difference in outcomes.”
— Dr. Merat Ostovar, DDS | Oral Surgery, Aloha Dental Specialty Center
Are You a Candidate for Impacted Tooth Extraction?
Most patients in good general health are candidates for impacted tooth extraction. However, certain factors may affect your eligibility or require modifications to the treatment plan:
- Medical conditions: Uncontrolled diabetes, autoimmune disorders, or blood-thinning medications may require coordination with your physician before treatment.
- Bone quality: For impacted tooth extraction involving the jawbone, adequate bone density is essential. A CBCT 3D scan during your consultation determines this precisely.
- Smoking: Tobacco use significantly impairs healing. We strongly recommend quitting 2-4 weeks before and after any surgical procedure.
- Age: There is generally no upper age limit. What matters is your overall health, not your age. We have successfully treated patients in their 80s and 90s.
The only way to know for certain is a consultation with our board-certified specialists. Call (503) 822-0096 to schedule your evaluation — we’ll tell you honestly whether this is the right treatment for your situation.
Typical Healing Timeline:
Days 1-3: Initial healing, mild swelling managed with ice and medication. Days 4-7: Swelling subsides, gradual return to normal diet. Weeks 2-4: Soft tissue heals completely. Months 2-6: Bone remodeling and full integration (for surgical procedures). Individual recovery varies — we provide detailed post-op instructions specific to your procedure.
For additional clinical information, visit the American Dental Association (ADA).
Last reviewed by our dental specialists: March 2026. Clinical information on this page reflects current evidence-based dental practices.
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Frequently Asked Questions
What teeth can become impacted besides wisdom teeth?
Any permanent tooth can become impacted, but after wisdom teeth, the most commonly impacted teeth are the upper (maxillary) canines, followed by lower (mandibular) second premolars and upper central incisors. Supernumerary teeth (extra teeth that develop beyond the normal dental formula) also frequently present as impacted. The maxillary canine is by far the most clinically significant non-wisdom-tooth impaction because of its importance in occlusion and aesthetics.
What is an impacted canine?
An impacted canine is a permanent canine tooth (the pointed tooth next to the front teeth) that has failed to erupt into its normal position in the dental arch. It remains partially or completely buried within the jawbone, often positioned palatally (toward the roof of the mouth) or labially (toward the lip). This occurs in about 2% of the population and is more common in the upper jaw than the lower.
What is the difference between extracting an impacted tooth and exposing it for orthodontic guidance?
Extraction permanently removes the tooth. Exposure and orthodontic guidance is a collaborative procedure where we surgically uncover the impacted tooth, bond an orthodontic bracket with a gold chain to its surface, and then the orthodontist applies gradual traction to guide it into the dental arch over months. Exposure is preferred for functionally important teeth like canines when their position makes eruption possible with orthodontic assistance.
What is a supernumerary tooth?
A supernumerary tooth is an extra tooth that develops beyond the normal complement of 20 primary or 32 permanent teeth. The most common type is the mesiodens, which forms in the midline of the upper jaw between the central incisors. Supernumerary teeth are often impacted and may block the eruption of adjacent permanent teeth. They are typically identified on routine dental radiographs and almost always require surgical extraction.
How is an impacted tooth diagnosed?
Impacted teeth are usually discovered when a permanent tooth fails to appear on schedule, when a dentist or orthodontist notices a missing tooth on clinical examination, or when routine dental X-rays reveal a tooth that has not erupted. CBCT three-dimensional imaging is the definitive diagnostic tool, showing the exact position, angulation, depth, and relationship to surrounding structures with precision that two-dimensional X-rays cannot provide.
Can an impacted tooth damage neighboring teeth?
Yes. An impacted tooth pressing against the root of an adjacent erupted tooth can cause external root resorption, which weakens and shortens the neighboring root over time. Impacted canines pressing against lateral incisor roots are a well-documented cause of resorption. Additionally, the follicular sac around an impacted tooth can develop into a dentigerous cyst that displaces adjacent teeth and destroys surrounding bone. Early detection through imaging prevents these complications.
What is surgical exposure and bonding?
Surgical exposure and bonding is a procedure where we create a small flap in the gum tissue, remove any bone covering the impacted tooth, dry and etch a small area on the tooth’s enamel surface, bond an orthodontic bracket with an attached gold chain, and reposition the flap. The chain is left accessible so the orthodontist can attach it to the archwire and apply directional force to slowly erupt the tooth into the arch over a period of months.
How long does it take for an exposed impacted canine to erupt into the arch?
The orthodontic eruption phase typically takes six to eighteen months depending on the depth of impaction, the distance the tooth must travel, and the patient’s biological response to orthodontic forces. Deeper impactions and those in older patients may take longer. The surgical exposure itself takes about 30 to 45 minutes; the majority of the treatment timeline is the orthodontic traction phase managed by the orthodontist.
Is impacted tooth surgery performed under sedation?
Local anesthesia is always used and is sufficient for many patients. IV sedation is available and commonly chosen for younger patients, for deeply impacted teeth requiring significant bone removal, or for patients who prefer to be completely relaxed during the procedure. Dr. Ostovar is IV sedation certified and monitors vital signs throughout. We discuss sedation options during the consultation.
What happens if an impacted tooth is left untreated?
Potential consequences of leaving an impacted tooth untreated include dentigerous cyst formation around the tooth crown, resorption of adjacent tooth roots, infection, and in rare cases transformation of the cyst lining into more aggressive pathology. The impacted tooth will never erupt on its own once it is diagnosed as truly impacted. Some impacted teeth remain asymptomatic for years, but the risk of complications increases with time, which is why evaluation and a clear management plan are important.
My orthodontist says my child needs an impacted canine exposed. What does that involve?
Your orthodontist and Dr. Ostovar will coordinate the treatment plan. The surgical procedure involves lifting a small section of gum tissue, removing a window of bone over the impacted canine, cleaning the enamel surface, bonding a small bracket with an attached gold chain, and closing the tissue. The chain protrudes through the tissue so the orthodontist can connect it to the braces and begin applying gentle force to guide the canine into the arch. The surgery takes about 30 to 45 minutes, typically under IV sedation for comfort.
What is tooth ankylosis and how does it affect impacted teeth?
Ankylosis occurs when the root of a tooth fuses directly to the surrounding bone, eliminating the periodontal ligament that normally allows slight tooth movement. An ankylosed impacted tooth will not respond to orthodontic traction because the bone-root fusion prevents movement. When ankylosis is suspected or confirmed on imaging, extraction rather than exposure is typically recommended because orthodontic eruption will fail. CBCT can sometimes suggest ankylosis before surgery based on the absence of a visible periodontal ligament space.
Does insurance cover impacted tooth extraction or exposure?
Most dental insurance plans cover surgical extraction of impacted teeth and surgical exposure for orthodontic purposes. Coverage amounts vary by plan. We verify your benefits before the procedure and provide a detailed estimate of out-of-pocket costs. If your child has both dental and medical insurance, there may be overlapping coverage for impacted tooth surgery. Our billing team navigates this for you.
What is a mesiodens and does it always need to be removed?
A mesiodens is a supernumerary tooth that develops in the midline of the upper jaw, between or behind the central incisors. It is the most common type of extra tooth. In most cases, yes, a mesiodens should be removed because it frequently blocks the eruption of the permanent central incisors, can cause root resorption of adjacent teeth, or may develop a cyst. Early detection and removal — often between ages six and eight — allows the permanent incisors to erupt naturally without additional orthodontic intervention.
How do I schedule an evaluation for an impacted tooth?
Call our Beaverton office at (503) 822-0096 to schedule a consultation. If you have been referred by an orthodontist or dentist, please bring or have them send any existing X-rays or treatment plans. We will take a CBCT scan during your visit if one has not been obtained recently, review the impacted tooth’s position in three dimensions, and discuss the recommended treatment approach — whether that is extraction, exposure, or monitoring.
Dealing with an Impacted Tooth? Get a CBCT Evaluation.
Call our Beaverton office or request an appointment online. We collaborate with orthodontists across Portland for impacted canine management.
Clinically Reviewed by Dr. Merat Ostovar, DMD
Doctor of Dental Medicine | Implant & Specialty Dentistry | 15+ Years Experience
Aloha Dental Specialty Center — Serving Aloha, Beaverton, Hillsboro & Greater Portland
Last updated: March 19, 2026