In the case of a patient with a permanent 2nd premolar almost in a horizontal impaction, what is the indicated action?

In the scenario of a patient presenting with a permanently impacted second premolar that is nearly horizontally positioned, the indicated action is to consult orthodontics for corrective treatment. This is primary because an orthodontic evaluation can provide guidance on the most effective approach to address the impaction. An orthodontist can assess the overall dental alignment and create a treatment plan that might include the use of braces or other appliances to facilitate successful eruption or reposition the impacted tooth appropriately.

In cases of horizontal impaction, extracting the tooth might not always be the first choice, as preserving the tooth is ideal if it can be brought into proper alignment. Monitoring alone may not be sufficient given the degree of impaction and the potential for complications such as root resorption of adjacent teeth or the development of periodontal disease. Surgical intervention could be an option, but typically, coordination with an orthodontist can help determine if surgery is necessary, and if so, how to most effectively prepare the tooth for surgical exposure or guide its eruption.

Thus, consulting orthodontics is an essential step for managing the impacted tooth while considering patient safety, tooth retention, and long-term dental health.