Impacted Canines


A tooth becomes impacted when it doesn’t have room to grow straight. This leads to impacted teeth, infections, and pain. Children can avoid this problem with an early partnership between the dentist, orthodontist and oral surgeon. Older children and teens may need a similar partnership to successfully address the issue. Older adults may have no choice left but to have the tooth removed.


The most common impacted tooth is one of the third molars. Most humans have four of these so-called wisdom teeth, but typically their mouths don’t have room for them. This is most likely to happen to older teenagers, but it can happen to anyone with their wisdom teeth still intact. Fortunately, these teeth are generally not needed, and removal can cure this problem quickly.


Another common tooth that may become impacted is the maxillary cuspid. This is also called the upper eyetooth. This tooth is essential for biting food. It actually helps guide all teeth to hold the proper bite. The roots are the longest of any human teeth. Since these are often the last front teeth to emerge, one or more may become impacted. This usually happens around age 13.

There are two common problems. In 60 percent of the cases, the tooth is stuck on the wrong side of the dental arch on the roof of the mouth. In other cases, the tooth gets stuck in an elevated position above the roots of the adjacent teeth or on the facial side of the dental arch.


At age seven, it is possible to determine where adult teeth will emerge. Using x-ray technology as well as medical know-how, the dentist can see if there is enough space. They can spot unusual growths or extra teeth. In some cases, orthodontics is the answer. In others, the best response is surgical extraction either of baby teeth that are in the way or of supernumerary (unneeded) teeth or unwanted growths. By clearing the path for the eyeteeth to come in straight, the oral surgeon helps the patient avoid an impacted tooth situation. In other cases, the oral surgeon may move the gum to encourage the tooth to come into the right spot. This will help the orthodontist who will then bracket it and pull it into place.

With older children or teenagers, an impacted eyetooth can be moved back into place but it will need help from braces and oral surgery. First the orthodontist uses braces to create the correct space for the eyetooth. At this point, the oral surgeon can move the gum out of the way and bond an orthodontic bracket to the impacted eyetooth. The gum is then moved back over the tooth, leaving a tiny gold chain. The orthodontist can then use the chain to begin the process of gently pulling the impacted tooth into place. This process may take a year or more to complete, but it will be worth it when the eyetooth is in the right place. In some instances, further gum surgery is required to cover the tooth’s new placement.


Removing such an important tooth is never the ideal option, but sometimes it becomes necessary. In cases involving an adult, especially one over age 40, the impacted eyeteeth will very likely need to be extracted. This will require a replacement such as a bridge or a dental implant.


If your treatment plan calls for oral surgery to expose the gum and add a bracket, you can expect it to take about 75 minutes for one tooth. A second tooth may stretch the time to 105 minutes. Sedation is available, but the surgery can be performed with local anesthesia or the use of laughing gas.

Patients can expect limited bleeding at the site. Since swelling may occur, you may want to apply an ice pack. Bruising may add to any pain or discomfort. This may be addressed with ibuprofen or acetaminophen. Until you feel comfortable chewing, a bland diet is recommended. You should avoid sharp food items such as chips and crackers that might jab the wound.

Within two to three days, patients are back to normal. In a week or ten days, you will return to the surgeon for a checkup. An orthodontist visit is usually advised from 1 to 14 days after the surgery.