Short answer: An impacted canine (eye tooth) is a tooth that has not erupted into the mouth at the expected age and remains inside the jawbone. It is usually treated by surgically exposing it and guiding it into place orthodontically. When it is noticed early, simpler approaches may sometimes be possible.
Why are canine teeth important?
Canines are the cornerstones of the dental arch. They influence the smile line, the support of the lower part of the face and the tooth guidance during side-to-side chewing movements. Upper canines usually erupt between the ages of 11 and 13. Impaction is most often seen in the upper jaw.
Causes
- Lack of space or crowding in the dental arch
- Late loss of the baby canine
- A small or missing neighbouring lateral incisor, because the root of this tooth guides the eruption of the canine
- Development of the tooth at the wrong angle inside the bone
- Genetic predisposition
- Rarely, obstacles such as a cyst or an extra tooth
How can you tell?
- Approaching the age of 14, the permanent canine still has not erupted.
- The baby canine is still in place and is not loose.
- The lateral incisors appear to have drifted sideways or are spaced.
- A slight bulge may be felt on the palate or the gum.
For late eruption of teeth in general, you can also read our article on what to do if your child’s teeth are late to erupt.
How is it diagnosed?
A panoramic X-ray shows the overall position of the tooth. If necessary, three-dimensional imaging is used to determine clearly whether the tooth lies on the palatal or cheek side, how close it is to the roots of neighbouring teeth and at what angle it lies. This information determines how the treatment will be carried out.
Treatment approach
Early intervention
During the mixed dentition period, at check-ups around the age of 10–11, the direction of the canine can be seen. In some cases, extracting the baby canine and creating space can help the permanent tooth erupt along its own path. You can find the general outline of this topic on our early orthodontic treatment page.
Creating space
Enough room is prepared in the arch so that the impacted tooth can erupt. Braces or clear aligners can be used for this purpose.
Surgical exposure and orthodontic traction
- The surgeon uncovers the gum and bone over the tooth with a small procedure.
- A small attachment is bonded to the surface of the tooth and a fine chain is connected.
- The orthodontist pulls the chain with light forces and guides the tooth into its place in the arch over several months.
- If needed, mini-screws or elastics are used as support.
The process varies with the position of the tooth, age and bone structure, and it generally takes several months.
Alternatives
If the tooth is very high, close to neighbouring roots or cannot be brought down, extracting it and closing the space with the neighbouring teeth, or completing it with an implant, may be considered. This decision is made jointly by the clinicians.
What happens if it is not treated?
An impacted canine can damage the roots of neighbouring teeth, create the conditions for a cyst to develop and disturb the alignment of the teeth. How likely these risks are varies from person to person, which is why regular orthodontic follow-up is important. You can find other orthodontic problems on our page on orthodontic problems we treat.
How does the treatment process work in practice?
- Imaging and planning: The position of the tooth is determined with an X-ray and, if needed, three-dimensional imaging.
- Preparing space: Enough room is opened in the dental arch with orthodontic appliances.
- Surgical exposure: The tooth is uncovered with a small surgical procedure and an attachment is bonded. The procedure is performed under local anaesthesia, and the necessary measures are taken for the patient’s comfort.
- Traction: With light forces, the tooth is guided into place over several months.
- Final adjustments and retention: The gum line, bite and tooth position are adjusted one last time, and then a retainer is provided.
Tips for parents
- When your child reaches 9–10 years of age, plan an orthodontic check-up and, if needed, a panoramic X-ray.
- If the baby canine is not loosening and the neighbouring teeth are drifting, see a dentist without waiting.
- Take care of oral hygiene after surgery and follow the clinician’s advice for gum healing.
- Do not skip check-up appointments, because the traction force needs to be adjusted regularly.
Impacted canines in adults
In adults, too, some impacted canines can be brought into place orthodontically; however, as age advances, the chance of the tooth fusing with the bone and the risk of gum recession are taken into account. For this reason, planning is done more carefully in adults and alternative options are discussed beforehand.
During the process, you need to brush carefully around the attachment and chain; poor hygiene can cause inflammation of the gum.
Frequently asked questions
Does an impacted canine erupt on its own?
In some early cases, extracting the baby tooth and creating space can make eruption easier. However, if the direction of the tooth is not favourable, orthodontic and surgical support is usually needed.
Can an impacted canine be pulled into place in adults?
It can be attempted in adults too, but if the tooth has fused with the bone (ankylosis), it may not move. For this reason, an assessment with imaging is made first.
Is treatment possible without extracting the canine?
In most cases the aim is to keep the tooth. If the position of the tooth is unfavourable, extraction and alternative plans are discussed; the decision is made after the examination.
How can you find out what suits you?
The information here is general; the right plan for you is determined by examination and clinical assessment. At our clinic in Oran, Çankaya, Ankara, we go through your questions together during the first orthodontic examination.
