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Impacted Canines

Humans have two upper (maxillary) canines and two lower (mandibular) canines. Canine teeth are sometimes referred to as cuspids, fangs, or “eye teeth” because of their direct positioning beneath the eyes. Canine teeth have thicker and more conical roots than incisors and thus have an especially firm connection to the jaw. Canine teeth often have the longest root of all teeth in the human mouth and the last to fully erupt and fall into place; often around age 13.

An impacted tooth essentially means that it is blocked, stuck, or unable to fully erupt and function properly. Third molars (wisdom teeth) most commonly fall victim to impaction, but the upper canine is the second most common tooth to become impacted. Wisdom teeth serve no important function in the mouth and are frequently removed; however, impacted canines are critical to the bite and require treatment for the following reasons:

  • Closing Gaps: Canines are the last of the front teeth to fall into place and therefore close any unsightly gaps between the other upper teeth.
  • First Touch: Canines play a vital role in the “biting” mechanism of the teeth. They touch first when the jaw closes, and guide the other teeth into position.
  • Proper Alignment & Function: Canine teeth are essential to the correct alignment and function of the other teeth on the dental arch. Missing or impacted canines can greatly affect the function and aesthetic appearance of the smile.

What Causes Canine Teeth To Become Impacted?

There are several main causes for impacted canine teeth:

  • Extra Teeth: If extra teeth are present, the natural eruption of the canine teeth may be inhibited. The eruption progress of the canine may be directly blocked by an extra tooth or the subsequent overcrowding might leave no room on the dental arch for the canine.
  • Overcrowding:  In some cases, poor alignment of the front teeth can lead to overcrowding. The existing teeth compete for space which means that the canines do not have sufficient room to become functional.
  • Unusual Growths:  On rare occasions, unusual growths on the soft tissue of the gums can restrict the progress of canine teeth, which leads to later impaction.

Early and thorough examination of the teeth can pre-empt problems with impacted canines. It is important for your dentist to document the number of teeth present when the patient is around 7 years of age in order to record the presence or absence of canine teeth. The older the patient becomes, the less likely it is that an impacted canine tooth will erupt naturally. If canine teeth are missing or very slow in fully erupting, your dentist can make recommendations for proper treatment.

In a simple surgical procedure performed in the surgeon's office, the gum on top of the impacted tooth will be lifted up to expose the hidden tooth underneath. If there is a baby tooth present, it will be removed at the same time.

Once the tooth is exposed, the oral surgeon will bond an orthodontic bracket to the exposed tooth. The bracket will have a miniature gold chain attached to it. The oral surgeon will guide the chain back to the orthodontic arch wire where it will be temporarily attached.

Shortly after surgery (1-14 days) the patient will return to the orthodontist. A rubber band will be attached to the chain to put a light eruptive pulling force on the impacted tooth. This will begin the process of moving the tooth into its proper place in the dental arch. This is a carefully controlled, slow process that may take up to a full year to complete. Remember, the goal is to erupt the impacted tooth and not to extract it!

You can expect a limited amount of bleeding from the surgical sites after surgery. Although there will be some discomfort after surgery at the surgical sites, most patients find Tylenol or Advil to be more than adequate to manage any pain they may have. Within 2-3 days after surgery there is usually little need for any medication at all. There may be some swelling from holding the lip up to visualize the surgical site; it can be minimized by applying ice packs to the lip for the afternoon after surgery. Bruising is not a common finding at all after these cases.

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