Impacted canines

Why canines get stuck

Upper canines have the longest journey of any tooth, developing high in the bone below the eye and travelling down along the root of the lateral incisor to arrive at around age eleven to thirteen. If the guiding root is misshapen or missing, if space in the arch has closed, or if the tooth is simply angled wrongly, it can lodge in the bone or drift toward the palate.

Why finding it early matters

An impacted canine can resorb the roots of the teeth beside it, permanently, and that damage is silent until it is visible on a radiograph. Detection at ten or eleven often allows a simple intervention — removing the retained baby canine and creating space — which lets the permanent tooth correct its own path in a meaningful proportion of cases. Detection at seventeen means surgical exposure and traction. This is among the strongest arguments for examining children before the permanent teeth are all through.

The treatment

1. Imaging. A three-dimensional scan locates the tooth precisely and shows whether neighbouring roots are affected.
2. Space. Braces open enough room in the arch first, because there is no point bringing a tooth down into a gap that is not there.
3. Exposure. A short surgical procedure uncovers the crown and bonds a small attachment with a gold chain to it.
4. Traction. The chain is connected to the archwire and light force is applied over months. Progress is slow and steady by design.
5. Alignment. Once the tooth is through, it is brought into the arch and rotated into position like any other.

What to expect

This adds meaningfully to treatment length — twenty-four to thirty-six months overall is common. The tooth appears to move very little for the first few months and then emerges relatively quickly. Success rates are high when the tooth is favourably positioned; an ankylosed canine, fused to the bone, occasionally will not move at all, in which case the plan changes to extraction and space management. That possibility is discussed before the exposure rather than after.