When you think about the term “impacted canines,” you might get a mental image of your golden retriever trying to get out of doggie jail after chewing up your favorite shirt.

That’s not the kind of impacted canine we’re discussing today. We’re talking about – you guessed it – teeth!

What is an impacted canine?

Your canine teeth are the pointy teeth that you might embellish when you dress as a vampire for Halloween. When they are impacted, it means they are blocked, stuck or otherwise prevented from fully erupting, even though their baby teeth counterparts have fallen out. Obviously, impacted canine teeth cannot function properly without orthodontic (or sometimes surgical) intervention.

Sometimes impacted canines erupt only partially. Others, they fail to erupt at all. They may appear labially, meaning above your gum line in front, or they can erupt palatally — in the roof of your mouth behind your teeth.

Benefits of interceptive treatment

If you’ve read any of my previous articles on this blog, you likely already know my opinion on the importance of having children evaluated by an orthodontist by age 7. Typically, no treatment is needed at this young age. However, this evaluation gives us an opportunity to collect diagnostic information on your child so we can monitor growth and identify whether problems such as impactions exist that would benefit from interceptive treatment.

We use an i-Cat 3D cone beam scanner in our office because this superior technology enables us to see things beneath the gums that X-rays cannot detect. These 3D scans reveal information about bone structure and tooth orientation. In panoramic images of the mouth, I can see whether enough room exists for the canines to erupt properly. And if it appears as though impaction may occur, I can provide interceptive treatment to address the issue.

This is an ideal time to treat such a condition because your child is still growing. I can use orthodontic appliances to help manipulate and guide your child’s jaw growth and teeth alignment to create the space needed for those canines to erupt properly when the time comes.

Treating impacted canines during adolescence

Many parents believe they should wait until their child has lost all baby teeth before scheduling an orthodontist’s

This palatally impacted canine was exposed via a surgical procedure.

This palatally impacted canine was exposed via a surgical procedure.

appointment, in spite of years of effort by the American Association of Orthodontists and us on the frontlines to educate the community on the importance of early evaluation.

Although interceptive treatment of impacted canines is the preferred treatment because it is less invasive, this condition can be adequately treated in adolescence. However, the process sometimes is more involved and can be more uncomfortable for your child.

Let’s say the impacted canine is partially erupted labially. If enough of the tooth has erupted, I may be able to bond a small appliance called an orthodontic traction hook to the tooth’s surface and link it to the arch wire with a tiny chain called a ligation chain. This method applies a constant force to the tooth to gradually guide and align it into the dental arch.

As the tooth erupts, chain links are removed one by one until an orthodontic bracket can be bonded to the tooth and connected to the arch wire.

Here’s another scenario: let’s say your child has a palatally impacted canine that isn’t erupted, and it is visible only in

An orthodontic traction hook has been bonded to the palatally impacted canine, and a ligation chain attached to guide it into proper position.

An orthodontic traction hook has been bonded to the palatally impacted canine, and a ligation chain attached to guide it into proper position.

an X-ray or i-Cat 3D scan. This is an instance that likely will require a multidisciplinary approach. I may refer you to an oral surgeon, who will surgically expose your child’s tooth. Then I can use the same process outlined above to guide the tooth into place.

This will result in some discomfort for a few days following the surgical procedure. Take a look at the two photos of this procedure. The chances are greatly increased that this method can be avoided when interceptive treatment is involved.

Complications we must watch for when impacted canines are present include bone loss, root resorption of adjacent teeth, and gingival recession around the treated teeth.

What causes teeth to become impacted?

Many parents want to know why their children’s canines are impacted once I give this diagnosis. We parents can be a guilty bunch, often wondering if there’s something we did to cause it, or something else we could have done to prevent it.

There are multiple theories why canines become impacted. Some scientists suggest that the canine teeth erupt along the root of the lateral incisor, which serves as a guide, according to a Journal of Pharmacy & BioAllied Sciences article. If the lateral incisor’s root is missing or malformed, it could mean the canine won’t erupt.

Genetics could be the cause of some impacted canines, and other dental issues such as missing or small lateral incisors also could be the culprit.

Parents, the bottom line is that this just happens sometimes. Following are some interesting statistics on this type of orthodontic condition.

Impacted Canines Facts & Statistics

  • The upper canines are the most commonly impacted teeth, second only to wisdom teeth, according to the Journal of Pharmacy & BioAllied Sciences article.
  • Impacted canine teeth in the upper jaw happens in about 2 percent of the population.
  • Females are twice as likely as males to have impacted canines.
  • The incidence of canine impaction in the maxilla is more than twice that in the mandible.
  • Eight percent of the population of patients with impacted canines have them bilaterally, meaning both of the canines in the upper or lower jaw are impacted.

Learn More

I hope you realize after reading this article that it’s never too late to correct orthodontic problems. Whether your child is 7 years old and in need of an initial orthodontic assessment, he or she is middle school age and clearly in need of braces, or you are interested in treatment as an adult, we here at Orthodontics Only can help.

Please call my office today to schedule a complimentary consultation. We will conduct a thorough assessment and offer treatment recommendations to best address any problems. We look forward to seeing you in the office soon.

1 Comment

  1. I have had this procedure done. My cuspid (bottom left canine) was impacted. A ligation was required to fix it. First I had to have braces so they could have something to attach the chain to. I felt nothing during the surgery. However, I was pretty sore the next day. I’ve had it for almost a year now (this January will be one year) my orthodontist has it pretty tight. It has not shown itself yet, but you can see where it has moved. It has straightened up, now we are pulling it away from the central incisor, to where the lateral incisor was (The tooth that was extracted). Soon enough we will bring them closer as I wear my braces. Dr. Keith Crawford is my orthodontist.

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