Orthodontic Related Surgery
Humans have two upper (maxillary) canines and two lower (mandibular) canines. Canine teeth are sometimes referred to as cuspids, fangs, or “eye teeth” because of their direct positioning beneath the eyes. Canine teeth have thicker and more conical roots than incisors and thus have an especially firm connection to the jaw. Canine teeth often have the longest root of all teeth in the human mouth and the last to fully erupt and fall into place, often around age 13.
An impacted tooth essentially means that it is blocked, stuck, or unable to fully erupt and function properly. Third molars (wisdom teeth) most commonly fall victim to impaction, but the upper canine is the second most common tooth to become impacted. Wisdom teeth serve no important function in the mouth and are frequently removed; however, impacted canines are critical to the bite and require treatment for the following reasons:
Closing Gaps – Canines are the last of the front teeth to fall into place and therefore close any unsightly gaps between the other upper teeth.
First Touch – Canines play a vital role in the “biting” mechanism of the teeth. They touch first when the jaw closes, and guide the other teeth into 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 greatly affect the function and aesthetic appearance of the smile.
What causes canine teeth to become impacted?
There are several main causes for impacted canine teeth:
- Extra Teeth – If extra teeth are present, the natural eruption of the canine teeth may be inhibited. The eruption progress of the canine may be directly blocked by an extra tooth or the subsequent overcrowding might leave no room on the dental arch for the canine.
- Overcrowding – In some cases, poor alignment of the front teeth can lead to overcrowding. The existing teeth compete for space which means that the canines do not have sufficient room to become functional.
- Unusual Growths – On rare occasions, unusual growths on the soft tissue of the gums can restrict the progress of canine teeth, which leads to later impaction. Early and thorough examination of the teeth can preempt problems with impacted canines. It is important for the dentist to document the number of teeth present when the patient is around 7 years of age in order to record the presence or absence of canine teeth. The older the patient becomes, the less likely it is that an impacted canine tooth will erupt naturally. If canine teeth are missing or very slow in fully erupting, the dentist can make recommendations for proper treatment.
The dentist initially conducts a thorough visual examination of the teeth, accompanied by a panorex x-ray and/or individual x-rays. Once the cause of the impaction has been determined, there will be several treatment options available depending upon the age of the patient. The objective is to aid the eruption of the impacted canines, and this can be skillfully done by the dentist, an oral surgeon, or an orthodontist.
What does the treatment of impacted canines involve?
- Treatment of impacted canines could involve extraction, surgical exposure for orthodontic movement, and no treatment.
- In regards to extractions, this usually will take place in adults if pathology is present, or to replace with a dental implant.
- On the other hand, no treatment is considered for adults when there is no pathology or need for a dental implant.
- In regards to a younger patient, orthodontic therapy is needed first to create a space in the dental arch for the impacted canine. Once this has been established, surgery will be undertaken to expose the canine. Once exposed, an orthodontic bracket is bonded to the tooth with an extended wire. The orthodontist will use this wire to move the canine into the provided space in the dental arch.