Expose Several Front Teeth with Laser

If baby front teeth are extracted too early because of cavities or injury, their permanent teeth usually have hard time to come out.  Without baby teeth, kids use the gums to chew.  They become so thick and tough for the permanent teeth to break through.  In proper time, the thick scar-like gums need to cut open to let the permanent teeth come through.

Kayla is 8 years old.  She has a history of early loss of baby front teeth on the top.  Now four adult lower front teeth are out (Fig.1 lower half: 2,1,1,2), but only one of top front teeth is out (2 on upper right corner of Fig.1, called lateral incisor), the other three (2,1,1) are still inside the gums.  Normally central incisors (1,1) erupt earlier than lateral ones (2,2).  Therefore, something is wrong with Kayla's gums, as mentioned above.

X-ray in Fig.2 shows 4 front teeth on the top.  One of central incisors (1 and ^) is lower than the other (1).

It is true clinically when Kayla raises her head a little bit (Fig.3).  In fact one corner of the central incisor (^) almost breaks through.

At least two of central incisors should be exposed, preferably with the unerupted lateral incisor.  Kayla's mom agrees.

Anesthetic is given (Fig.4 *).  Kayla starts to cry.  Her mom worries and asks whether to open the easiest one first.  Of course.  Here we go.  The gums are cut open with laser without any bleeding (^).  Although the wound looks burnish (charcoal), it usually heals fast and without pain.  Laser has anti-inflammatory effects.

Two months later, this central incisor is born nicely (Fig.5, as compared to Fig.1).  The other two front teeth are still snoring underneath the gums.  With the permission from Kayla's mom one more time, the other unborn front teeth are given windows to come out (Fig.6).

Update will be provided in 1 or 2 months.  Is waiting not exciting?

Xin Wei, DDS, PhD, MS 1st edition 06/04/2012, last revision 06/05/2012