Impacted
Canines

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, which can get “stuck” in the back of the jaw and develop painful infections and other issues. However, the maxillary cuspid (upper eyetooth) is the second most common tooth to become impacted. The cuspid tooth is crucial in the dental arch and plays an important role in your bite. These teeth are strong and have the longest roots of any human teeth, designed to be the first teeth that touch when your jaws close, guiding the rest of the teeth into the proper bite.

Early Recognition is Key

The older the patient, the more likely an impacted eyetooth will not erupt naturally, even if space is available. The American Association of Orthodontists recommends a panorex screening x-ray and dental examination around age seven to count the teeth and identify any eruption problems. Issues such as missing adult teeth, extra teeth, unusual growths, extreme crowding, or too little space may cause problems with the eruption of the eyetooth.

Treatment for Impacted Canines

Orthodontics: If a problem is identified, an orthodontist may place braces to open spaces and allow for proper eruption of the adult teeth.

Oral Surgery: An oral surgeon may be needed to extract over-retained baby teeth, remove any extra teeth or growths blocking eruption, and expose and bracket the impacted eyetooth.

Surgical Procedure

In cases where the eyeteeth do not erupt spontaneously, the orthodontist and oral surgeon work together. The orthodontist places braces on the teeth and opens a space for the impacted tooth. The patient is then referred to the oral surgeon to expose and bracket the impacted eyetooth in a straightforward procedure. The gum over the impacted tooth is lifted to expose the hidden tooth, and an orthodontic bracket with a small gold chain is bonded to the tooth. The chain is attached to the orthodontic arch wire, and the gum is sutured back, leaving only the chain visible.

Shortly after surgery, the patient returns to the orthodontist to begin moving the tooth into its proper place using a light eruptive force. This slow process may take up to a year, with the goal being to erupt the impacted tooth rather than extract it. Once the tooth is in its final position, the gum around it is evaluated to ensure it is strong and healthy enough for lifelong function.

Expectations After Surgery

After surgery, patients can expect limited bleeding and some discomfort, manageable with Tylenol or Advil. Swelling may occur but can be minimized with ice packs. A soft diet is recommended initially. Patients should avoid sharp foods that could irritate the surgical site. The surgeon will evaluate healing seven to ten days after surgery, and the orthodontist will begin the eruption process within one to fourteen days.

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