What Is an Impacted Tooth?
Second to wisdom teeth, the maxillary canine (upper eyetooth) is a common tooth to become impacted (stuck below the gumline). Canine teeth are very strong biting teeth and have the longest roots of any human teeth. They are the first teeth that touch when the jaws close, so they guide the rest of the teeth into a proper bite position.
Normally, maxillary canines are the last of the front teeth to come in, usually around age 12. If a canine is impacted, certain techniques can help.
Having Impacted Canine Surgery
Early Recognition and Screening
Early recognition of impacted eyeteeth is key to successful treatment. The older the patient, the more likely an impacted canine will not erupt on its own even if the space is available for the tooth to fit in the dental arch. The American Association of Orthodontists recommends that children be screened starting at age 7.
Sometimes treatment requires extraction of baby teeth or adult teeth that are blocking eruption of the canines. If the eruption path is cleared and the space is opened by ages 11-12, there is a good chance the impacted canine will erupt on its own. If the canine is allowed to develop too much, ages 13-14, the impacted tooth will not erupt by itself even with space cleared. For patients over age 40, there is a much higher chance the tooth will be fused in position, which requires removal and then a replacement tooth like a crown on a dental implant or a fixed bridge.
Teeth That Do Not Erupt
In cases where canines do not erupt on their own, the orthodontist and oral surgeon work together. The orthodontist places braces on the teeth, with a space to provide room for the impacted tooth to be moved into its proper position. If the baby canine has not fallen out already, it may be left in place until space for the adult canine is ready. Once space is ready, the orthodontist will refer the patient to the oral surgeon to have the impacted canine exposed and bracketed.
Once the tooth is moved into its final position, the gum around it is evaluated to make sure it is sufficiently strong and healthy. Sometimes, minor gum surgery is needed to add bulk to the gum tissue.
Impacted Canine Braces
Surgery to expose and bracket an impacted tooth is performed in the office, usually under IV sedation.