What is an impacted canine?
An impacted tooth simply means that it is “stuck” and unable to erupt into its proper position.
While wisdom teeth are the most commonly impacted teeth, the maxillary canine (upper eyetooth) is the second most common tooth to become impacted.
The canine tooth is extremely important because it:
- Has the longest root of any tooth
- Is one of the strongest biting teeth
- Helps guide your bite into proper alignment
- Plays a key role in both function and facial esthetics
Because of its importance, every effort is made to bring an impacted canine into the dental arch rather than remove it.
When do canines normally erupt?
Upper canines typically erupt around age 11–13 and are usually the last of the front teeth to come into place.
If a canine does not erupt on time, it may be:
- Positioned toward the roof of the mouth (about 60% of cases)
- Located within the jaw bone above adjacent tooth roots
- Positioned toward the facial (lip) side
- Blocked by baby teeth, crowding, or extra teeth
Early recognition is critical
Early identification greatly improves success.
The American Association of Orthodontists recommends that children have a panoramic X-ray around age 7 to:
- Confirm all adult teeth are present
- Identify eruption problems early
If detected early (around age 11–12), clearing the eruption path and creating space may allow the canine to erupt naturally.
If allowed to remain impacted beyond age 13–14, the tooth is much less likely to erupt on its own.
In older adults, the tooth may even become fused (ankylosed), making eruption impossible. In those rare cases, extraction and replacement (implant or bridge) may be necessary.
How are impacted canines treated?
Step 1: Create space
The orthodontist places braces and opens space in the dental arch for the canine. If baby teeth are still present, they may be left temporarily until space is ready.
Step 2: Surgical exposure & bracketing
Once space is available, a minor surgical procedure is performed in our office. During this procedure:
- The gum tissue is gently lifted
- The impacted tooth is exposed
- A small orthodontic bracket is bonded to the tooth
- A gold chain is attached to guide eruption
The gum tissue is usually repositioned, leaving only the small chain visible.
Step 3: Guided eruption
Within 1–14 days after surgery, the orthodontist attaches a small elastic to the chain.
A light, controlled force is applied to slowly guide the tooth into position.
This is a gradual process and may take 6–12 months.
The goal is always to preserve and position the natural tooth — not extract it.
What if the tooth does not erupt?
In some cases — especially in older patients — the impacted canine may not respond to orthodontic traction.
If the tooth is fused or severely displaced, alternative treatment options such as extraction and implant replacement may be considered.
Each case is evaluated individually.
What to expect from surgery
Surgical exposure of an impacted canine is a straightforward procedure performed in our office.
Anesthesia options
Most patients are treated with:
- Local anesthesia with nitrous oxide (laughing gas)
- IV sedation
After surgery you can expect:
- Mild swelling
- Minor bleeding
- Mild discomfort
- Most patients manage discomfort with Tylenol or Advil.
Ice packs applied to the lip for the first several hours help reduce swelling.
A soft diet is recommended for the first few days. Avoid sharp or crunchy foods that may irritate the surgical site.
You will return in 7–10 days for evaluation and then follow up with your orthodontist shortly after to begin eruption.
Special situations
It is not uncommon for both upper canines to be impacted. In these cases, both teeth can typically be exposed and bracketed during the same visit.
Front teeth and premolars are generally easier to move orthodontically than molars because they have single roots and smaller size.
Risks
As with any procedure, risks may include:
- Swelling
- Infection
- Discomfort
- Failure of the tooth to erupt
- Need for additional gum grafting if tissue is thin
Fortunately, when identified early and treated appropriately, impacted canines have a very high success rate.
- Our philosophy
Impacted canines are common — but timing matters. Early diagnosis and coordinated care between the orthodontist and oral surgeon provide the best chance of success. Our goal is always to preserve natural teeth, guide them safely into position, and support long-term dental health.
Frequently asked questions
Answers to the questions we hear most from patients.
