THE MANAGEMENT OF IMPACTED CANINES

What are canine teeth?

Normally, each person has two canine teeth in the upper and lower jaw. They are the 'pointier' "eye teeth" that are in line near the corner of the mouth.

Canine teeth are more important than some other teeth for the correct function of the teeth and also for appearance. This is why dentists and orthodontists like to correct their position if possible.

When do permanent canine teeth appear?

Normally, the adult canine teeth appear in the mouth between the ages of 11 and 13 years and can often be felt under the gum just before they erupt.

What can go wrong with canine teeth?

Sometimes one or both canine teeth grow in the wrong direction for normal appearance or function or even not at all.

What can a misplaced canine look like?

Canines can fail to grow completely on one or both sides; this can either leave a gap between the adjacent teeth.

Misplaced canines can also grow in the wrong place. They can erupt at the wrong angle or even behind the teeth in the palate.

What will happen if I have a misplaced canine?

The treatment options for impacted or misplaced canines will depend on the type and severity and the alignment of other teeth. Your dentist, orthodontist and/or oral and maxillofacial surgeon will explain the options to you, which can include surgery.

What might happen if I decide not to have treatment for my impacted canine tooth?

If an impacted canine is not treated, it can just remain buried and give you no more problems. Alternatively, it can lead to the following, which might or might not give you problems in the medium-long-term:

  • The tooth can continue to grow behind the other teeth in the roof of the mouth. In an effort to find a path into the mouth, some impacted canines might damage adjacent teeth by eating away or resorbing part of their roots, which might or might not give you problems.

  • If the deciduous canine has been lost and the permanent canine remains impacted, you might have a gap, which you might want to close up or replace with a false tooth of some kind (denture or 'bridge').

  • Sometimes a cyst can form around the crown of the buried tooth and this can push other teeth out of position.

If you have an impacted canine, you do not have to have surgery - this will be explained by your dentist or orthodontist. For example, if the buried tooth has not damaged the adjacent teeth, is not causing symptoms and the dental appearance is good then no treatment might be necessary.

What can be done surgically for impacted canine teeth?

There are several options for the surgical treatment of impacted canines. Your dentist will explain the options for you which might include:

  • Removed and discarded - This can be the treatment of choice if the buried tooth is in a poor position for orthodontic re-alignment, or shows signs of causing problems to adjacent teeth.

    If there is a gap to fill where the canine tooth should be, there is usually an option of using a false tooth to "fill the space"

  • Exposed before orthodontic treatment - If part of the tooth is exposed to the mouth it can allow an orthodontist to move it into correct alignment. This can be an option  if the buried tooth is in a reasonable alignment and the patient is prepared to undergo orthodontics. 

    The exposure of the tooth involves a small operation which is often performed under anaesthesia. During this operation, some gum and bone overlying the tooth is removed so that the crown of the tooth is exposed. Often a gold chain will be bonded to the tooth to aid the orthodontist to move the tooth into alignment.

Figure: A enlarged picture of a gold chain

Figure: Gold chain bonding example to an impacted canine