Impacted Teeth
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 the proper bite position.
Normally, the 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.
Early Recognition and Screening
Early recognition of impacted eye teeth is the 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 the eruption of the canines. If the eruption path 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 the 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.
Eyeteeth That Do Not Erupt
In cases where the canines do not erupt on their own, the orthodontist and oral surgeon work together. The oral surgeon can perform a simple procedure that lifts the gum to expose the impacted tooth and then remove a baby tooth if present. Once exposed, an orthodontic bracket is bonded to the exposed tooth.
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 tissue.
Impacted Canine Braces
Because anterior teeth (incisors and cuspids) and premolar teeth are small with single roots, it is easier for them to erupt if they are impacted. The much larger molar teeth have multiple roots, making them more difficult to move. Surgery to expose and bracket an impacted tooth is performed in the office, usually under IV sedation.