An impacted tooth is a tooth that is stuck and unable to fully emerge and function. Wisdom teeth are the most common teeth to become impacted. However, for most people the wisdom teeth generally have no critical purpose in the mouth and the treatment for their impaction is simply removal.
The maxillary canine tooth (cuspid, fang or “eye teeth”) is the second most common tooth to impact. Unlike wisdom teeth, the canines are highly important to both the function and the appearance of the bite. Careful and timely treatment of impacted canines is directed at having the tooth emerge and position properly for a lifetime of optimal oral health.
Canines are critical to the bite and require treatment for the following reasons:
- Closing Gaps – Canines are typically the last of the front teeth to come into place and help close any unsightly gaps between the other upper teeth.
- First Touch – Canines typically touch first when the jaw closes, and guide the other teeth into the proper bite position.
- Proper Alignment & Function – Canine teeth are essential to the correct alignment and function of the other teeth on the dental arch. Missing or impacted canines can also negatively impact the cosmetic appearance of the smile.
Normally, the maxillary canine teeth are the last of the front teeth to erupt into place. They usually erupt into the mouth around age 9–10. If they erupt appropriately, the canines will usually cause any space left between the upper front teeth to close tightly together. A successful and timely eruption is therefore an important part of having a good bite and an attractive smile.
What causes canine teeth to become impacted?
There are several main causes for impacted canine teeth:
Extra Teeth – Extra teeth can either directly block the eruption path, or create overcrowding which interferes with the natural eruption of the canine.
Overcrowding – Overcrowding may be the result of poor alignment of the front teeth as well as extra teeth. In either case, the result may be insufficient space for the canines to properly emerge.
Unusual Growths – Rarely, growths on the soft tissue of the gums can interfere with eruption and lead to impaction of the canines.
If a cuspid tooth gets impacted, every effort is made to get it to erupt into its proper position in the dental arch. While the techniques involved to aid eruption can be applied to any impacted tooth in the upper or lower jaw, they are most commonly used with the maxillary cuspid. The older the patient, the more likely an impacted eye tooth will not erupt by nature’s forces alone even if space is available. 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 age 7 to count the teeth and determine if there are potential problems with eruption of the adult teeth.
The cause of an impaction will be determined through a thorough visual examination of the teeth, accompanied by a panorex X-ray and/or individual X-rays. After the cause of the impaction is identified by the dentist, treatment options appropriate to the age of the patient will be recommended. The objective is to aid the eruption of the impacted canines, and this can be skillfully done by the oral surgeon in conjunction with orthodontic treatment.
What does the treatment of impacted canines involve?
The dentist may recommend extraction of teeth to resolve overcrowding or to remove any extra teeth (supernumerary teeth) or growths that are blocking the eruption path of any of the adult teeth. The extraction will generally be performed under local anesthetic by an oral surgeon. Treatment may also require a referral to an oral surgeon for extraction of over retained baby teeth and/or selected adult teeth that are blocking the eruption of the important canine teeth. If the eruption path is cleared and the space is opened up by age 11 or 12, there is a good chance the impacted canine tooth will erupt with nature’s help alone. In some cases, the un-erupted canine may be exposed by surgically lifting the gum, and guided into place using a special bracket. In the case of younger patients, orthodontic treatment may be used to create or maintain a space in the dental arch for the impacted canine.
Surgery for impacted canines usually does not require an overnight stay. Pain medication will be prescribed as necessary, and you’ll be given post treatment advice for your optimum recovery.