Surgery to Assist Orthodontics in the Ballantyne Area
Oral surgeons and orthodontists frequently work together to improve treatment outcomes. Braces and aligners are very good at moving teeth — but when a tooth is impacted below the gum, has tipped out of position, needs a fixed point to push against, or is being held back by restrictive soft tissue, surgical assistance is what makes the orthodontic plan possible.
At West Ballantyne Oral Surgery, Dr. George Y. Soung is a board-certified Oral and Maxillofacial Surgeon who performs expose and bond, surgical exposure and uprighting, temporary anchorage device (TAD) placement, and frenectomy in support of orthodontic treatment. He works directly with your orthodontist so each surgical step fits the plan they have already set for you, and most major insurance plans are accepted here.
Procedures Dr. Soung Performs for Orthodontic Patients
Each of these is a short, focused procedure done in our office. None of them changes your orthodontic plan — they clear the way for it.
Expose and Bond of an Impacted Tooth
When a permanent tooth is stuck below the gumline and will not come in on its own — most often an upper canine — it cannot be moved by braces alone, because there is nothing to attach to. Dr. Soung uncovers the tooth through a small opening in the gum tissue and bonds a bracket with a fine gold chain to it. Your orthodontist then uses that chain to guide the tooth gently into its proper position over the following months.
Surgical Exposure and Uprighting
A tooth that has tipped or drifted out of its upright position — commonly a lower molar that has leaned into a space left by an earlier extraction — can be surgically exposed and repositioned so it stands correctly in the arch. Uprighting restores a usable biting surface, makes room for orthodontic movement or a future restoration, and protects the health of the bone and gum tissue around the tooth.
Temporary Anchorage Device (TAD) Placement
Moving one tooth means pushing against something else, and in orthodontics that anchor is often other teeth — which can drift out of position in the process. A temporary anchorage device is a small titanium mini-screw that Dr. Soung places into the bone to give your orthodontist a fixed, immovable point to work from. That allows more precise and often faster tooth movement without unwanted shifting elsewhere in the arch. Placement takes only a few minutes under local anesthesia, and the TAD is removed just as easily once it has done its job.
Frenectomy
A frenum is the small band of tissue connecting the lip or tongue to the gums. When it is unusually tight or attaches too low, it can hold a gap open between the front teeth, pull on the gum tissue and cause recession, or restrict tongue movement. A frenectomy releases that band of tissue. It is a brief procedure, and when it is done as part of orthodontic treatment it helps the teeth close and stay closed rather than relapsing after the braces come off.
Your Orthodontist May Refer You
Impacted Canine
An upper canine that has not erupted on schedule.
No Eruption Path
A tooth blocked by crowding or by a neighbouring tooth.
Tipped Molar
A molar that has leaned into an adjacent space.
Anchorage Needed
A TAD to give precise, controlled tooth movement.
Restrictive Frenum
Tissue holding a midline gap open or pulling on the gums.
Which Procedure Does Your Orthodontist Mean?
All four support orthodontic treatment, but they solve different problems. Your orthodontist will have already identified which one applies to you — this table is here so the referral makes sense before you arrive.
| Procedure | The Problem It Solves | What Dr. Soung Does | What Happens Next |
|---|---|---|---|
| Expose and Bond | A tooth that has not erupted and is stuck below the gum — most often an upper canine | Uncovers the tooth and bonds a bracket and fine gold chain to it | Your orthodontist guides the tooth into position using the chain |
| Surgical Exposure and Uprighting | A tooth that has erupted but tipped out of position — commonly a lower molar | Exposes and surgically repositions the tooth so it stands upright in the arch | Your orthodontist stabilises the new position |
| Temporary Anchorage Device (TAD) | Tooth movement that needs a fixed anchor so other teeth do not drift | Places a small titanium mini-screw into the bone, in a few minutes | Your orthodontist moves teeth precisely against it; the TAD is removed afterward |
| Frenectomy | A tight frenum holding a gap open, pulling on the gums, or restricting the tongue | Releases the band of tissue in a brief procedure | Teeth can close and stay closed rather than relapsing after treatment |
If your orthodontist has asked for teeth to be removed rather than repositioned — including crowded or supernumerary teeth — see our Tooth Extractions page.
What to Expect: From Referral to Recovery
Your Consultation with Dr. Soung
You will meet with Dr. Soung for a focused exam. He reviews your orthodontist’s records, takes a 3D scan on site if the tooth’s position needs to be mapped precisely, and explains exactly what the procedure involves and how it fits into your orthodontic timeline. Bring your questions — nothing about this appointment is rushed.
The Procedure
All of these are done in our office and are typically finished in well under an hour. Most patients choose local anesthesia; moderate-to-deep IV sedation is available if you would rather be sedated. Dr. Soung performs the surgery himself, and you go home the same visit.
Recovery and Coordination with Your Orthodontist
Expect mild soreness and some swelling for a few days, managed with over-the-counter medication and a soft diet. Most patients are back to normal activity the next day. We send a report to your orthodontist, and they will usually resume active treatment within a couple of weeks so the tooth can begin moving.
Sedation and Comfort Options
You do not need to feel anxious about the procedure itself. These are short procedures, and most patients are comfortable with local anesthesia alone — Dr. Soung takes particular care to numb the area slowly and gently. If you or your child would rather be sedated, moderate-to-deep IV sedation is available and Dr. Soung is formally trained to sedate both adults and children. Learn more about your options on our Sedation & Anesthesia page.
Frequently Asked Questions About Surgery to Assist Orthodontics
An expose and bond is a short procedure for a permanent tooth that is impacted — stuck below the gumline with no path to erupt on its own. Dr. Soung uncovers the tooth and bonds a small bracket with a fine gold chain to it. Your orthodontist then uses that chain to guide the tooth into position over the following months. It is most commonly needed for an impacted upper canine.
A tooth that has tipped or drifted — often a lower molar leaning into the space left by an earlier extraction — does not bite properly and can make orthodontic movement or a future crown or implant difficult to plan. Uprighting repositions the tooth so it stands correctly in the arch, restoring a usable biting surface and protecting the surrounding bone and gum tissue.
Not at this practice. Dr. Soung trained extensively in corrective jaw surgery during his residency, but the orthodontic support he provides here is expose and bond, surgical exposure and uprighting, temporary anchorage device placement, and frenectomy. If your orthodontist has recommended jaw surgery, call our office and we will help point you in the right direction.
Most patients have mild soreness and some swelling for a few days, managed with over-the-counter pain medication and a soft diet. Nearly everyone is back to work or school the next day. Your orthodontist will usually resume active treatment within a couple of weeks.
Coverage depends on your plan. West Ballantyne Oral Surgery is in-network with many major insurers, including Blue Cross Blue Shield, Cigna, Delta Dental, and UnitedHealthcare. Our team can check your benefits before treatment. Visit our Insurance & Financing page for more details.
Most patients for these procedures do come from a referring orthodontist, since it is usually the orthodontist who identifies the need. A referral is not required, though — if you have a concern about a tooth that has not come in or has tipped out of position, call our office directly.
Ready When You Are
Whether you are coming in for a wisdom teeth consultation, an implant evaluation, or an urgent situation, we will take care of you. Step into a practice designed with your comfort and ease in mind.