Impacted Canines

An impacted tooth simply means that it is “stuck” and cannot erupt into function. Patients frequently develop problems with impacted third molar (wisdom) teeth. These teeth get “stuck” in the back of the jaw and can develop painful infections among a host of other problems (see Impacted Wisdom Teeth under Procedures). Since there is rarely a functional need for wisdom teeth, they are usually extracted if they develop problems.

The canine tooth (cuspid or eyetooth) is the second most common tooth to become impacted. It is a critical tooth in the dental arch and plays an important role in your “bite”. The canine teeth are very strong biting teeth and have the longest roots of any human teeth. They are designed to be the first teeth that touch when your jaws close together so they guide the rest of the teeth into the proper bite. So whenever possible, every effort should be made to help these impacted teeth into position.

Early Recognition Of Impacted Canine Teeth Is The Key To Successful Treatment

The older the patient, the less likely an impacted canine tooth will erupt by nature’s forces alone, even if the space is available for the tooth to fit. The American Association of Orthodontists recommends that a panorex screening x-ray, along with a dental examination, be performed on all dental patients at around the age of seven years to count the teeth and determine if there are problems with eruption of the adult teeth. It is important to determine whether all of the adult teeth are present, whether some are missing, or whether any extra teeth exist. It is also a great time to determine whether anything (like teeth) is blocking the eruption of the canine teeth.

This exam is usually performed by your general dentist or hygienist who will refer you to an orthodontist if a problem is identified. Treating such a problem may involve an orthodontist placing braces to open spaces to allow for proper eruption of the adult teeth. Treatment may also require referral to an oral surgeon for extraction of over-retained baby teeth and/or selected adult teeth that are blocking the eruption of the all-important canine teeth.

If the eruption path is cleared and the space is opened up by age 11-12, there is a good chance the impacted canines will erupt with nature’s help alone. If it is allowed to develop too much (age 13-14), the impacted canine will not erupt by itself even with the space cleared for its eruption. If the patient is too old (over 40), there is a much higher chance the tooth will be fused (ankylosed) in position. If the tooth is ankylosed, it will not budge despite all the efforts of the orthodontist and oral surgeon to erupt it into place. Sadly, the only option at this point is to extract the impacted tooth and consider an alternate treatment to replace it in the dental arch (crown on a dental implant or a fixed bridge). So the sooner an impacted canine is identified, the better.

What Happens If The Canine Tooth Will Not Erupt When Proper Space Is Available?

In cases where the canine will not erupt spontaneously, the orthodontist and Dr. Konys work together to help get these impacted teeth to erupt. Each case must be evaluated on an individual basis, but treatment will usually involve a combined effort.

The most common scenario will call for the orthodontist to place braces on the teeth (at least the upper arch). A space will be opened to provide room for the impacted tooth to be moved into its proper position in the dental arch. If the baby eyetooth has not fallen out already, it is usually left in place until the space for the adult eyetooth is ready. Once the space is ready, the orthodontist will refer the patient to Dr. Konys to have the impacted canine exposed and bracketed. Dr. Konys has successfully performed thousands of these procedures. To aid in the procedure, a three-dimensional image may be taken at the time of your consult with Dr. Konys to help locate the exact position of the impacted tooth.

If surgery is deemed the best solution to an impacted canine, a simple surgical procedure is performed in our office to uncover the tooth. If there is a baby tooth present, it will be removed at the same time. Once the tooth is uncovered, Dr. Konys will bond an orthodontic bracket to the exposed tooth. The bracket will have a miniature gold chain attached to it that the orthodontist uses to gently direct the impacted tooth into position.

Why do I need to see Dr. Konys for a consult before treating my impacted canine?

Not all impacted canine teeth are alike. In his many years of practice, Dr. Konys has seen them in all shapes, sizes, and positions. So it is really important to have him evaluate each one before surgery. Typically your dentist or orthodontist will send you with x-rays of the tooth. If they are helpful, Dr. Konys will use them. However, in most cases his staff will perform a quick three-dimensional film to identify the exact position of the tooth.

During the consultation visit, Dr. Konys will review your options, describe the procedure specific to your tooth, and give you realistic expectations for your post-operative course. In addition, he will discuss the various anesthetic options that are available. Most importantly, since most of our patients with impacted canines are kids, it gives you an opportunity to meet all of us, see our state-of-the art facility, and become completely comfortable with us. We love questions, so this is a great time to ask them!