What are the options if my child's Canine or "Eye" teeth don't come through the gums?

Impacted Canine or "Eye" teeth

~ Dr Abhishek Mogre DMD, Board Certified Oral & Maxillofacial Surgeon

Are canines or “Eye Teeth” commonly impacted? 

- Maxillary canine tooth is the second most common tooth to become impacted. An Impacted       tooth simply means that its “Stuck” or not able to erupt in proper functional position. 

Is it a better choice to bring Impacted Canine in proper position or just to extract it? 

- Canines play a critical role in occlusion or “Bite”. Canines have the longest and strongest roots and their position in the arch helps them to guide the rest of the teeth into proper bite. If a canine is impacted, every effort should be made to assist its eruption in proper functional position, with the help of an Orthodontist. Extraction or removal of impacted canines should not be a first choice. 

- An impacted canine is seen to be positioned on the palatal aspect in relation to the other teeth, 60% of the time. 

CBCT or "3D scan" image of Dr Mogre's patient shows a lower left permanent canine tooth
failing to erupt in normal jaw position.

What is the best time to treat a potential problem involving impacted canines? 

- Early recognition of the problem remains the key. Usually, patients General Dentist/Pediatric Dentist or Hygienist will identify the problem and make a referral to an Orthodontist. The orthodontist will then evaluate and make appropriate referral to an Oral Surgeon for removal of baby teeth or extra/supernumerary teeth to allow space for normal eruption of canines. 

- Many times, just removal of baby teeth or extra teeth may not be sufficient to solve the issue, and an Oral Surgeon will need to surgically expose the canines and attach special brackets and chain to those impacted canines. The orthodontist then uses special elastic bands to bring the canines in proper position. 

Dr Mogre performed
Surgical Exposure of impacted canine.

Attaching a gold bracket with chain to the canine

Panoramic X ray of Dr Mogre's patient, shows the attached bracket and chain to the impacted canine tooth.

What is a normal recovery time after such an “Expose and Bond” procedure for Impacted Canines? 

- Surgical recovery involves 24-48 hrs of mild discomfort. Pain is well controlled with tylenol or Advil. Patient should start a soft and bland diet for 24-48 hours and then advance towards regular diet as tolerated. Patients should care for their oral wound by rinsing and gently brushing to avoid any food retention.

Are there any other concerns? 

- Surgical exposure and bond of Impacted canine teeth is a common procedure with low risks/complications. Sometimes the special bracket can de-bond, during the assisted orthodontic treatment, and may need to be reattached. Usually, the impacted canine is exposed in the oral cavity and the reattachment can be easily performed in the orthodontist’s office. If the soft tissue is covering the canine, then the Oral Surgeon may need to re expose the canine, and attach the bracket in his office.

What are the choices for Anesthesia for this procedure?

- A typical surgery of Expose and Bonding of Impacted canines is performed under IV sedation and local anesthesia. Patients are instructed to remain empty stomach for 8 hours prior to their surgery under IV Sedation. Please refer to our Anesthesia section of the website for details about IV sedation. 

Simply call Shoreline Oral Facial Surgery & Dental Implants at 650-965-2222 if you have any questions.