Impacted Canines

The maxillary cuspid (upper eyetooth) is the second most common tooth to become impacted. Normally, the maxillary cuspid teeth are the last of the “front” teeth to erupt into place. The cuspid tooth is a critical tooth and plays an important role in your “bite”. They usually come into place around age 13 and cause any space left between the upper front teeth to close. If a cuspid tooth gets impacted, every effort is made to get it to erupt into its proper position in the dental arch.

In cases where the cuspid will not erupt spontaneously, they orthodontist and oral surgeon will work together to get these 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. A space will be opened to provide room for the impacted tooth to be moved into the dental arch. Once the space is ready, the orthodontist will refer the patient to the oral surgeon to have the impacted tooth exposed and bracketed.

If the cuspid is allowed to develop too much under the surface (by age 13-14), the tooth will not erupt by itself, even with the space cleared for its eruption. If the patient is older (over 40), there is a much higher chance that the tooth will be fused in position. In these cases, the tooth will not budge despite all the efforts of the orthodontist and oral surgeon to erupt it into place. The only option at this point is to extract the impacted tooth and consider an alternate treatment to replace it in the dental arch (dental implant or a fixed bridge).

In a simple surgical procedure performed in the surgeon’s office, the gum on top of the impacted tooth will be lifted 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. 

If you think you might need to have your Impacted Canines evaluated, call our office today and we will be happy to further assist you.