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Expert guide to impacted canine tooth treatment in the UK. Learn about symptoms, orthodontic exposure surgery, recovery and success rates from specialists.
If you’ve been told you or your child has an impacted canine tooth (also known as an ingrown canine tooth), know that you’re not alone. The good news? Effective treatment options are readily available here in the UK. And with expert care, you can achieve a healthy, well-aligned smile.
First up, what exactly is an impacted canine tooth? An impacted canine tooth is a canine tooth that has failed to erupt properly into the mouth and remains stuck beneath the gums or buried in the jawbone. Your permanent canine teeth usually appear between the ages of 11 and 13, so if they haven’t emerged by this time, there may be an issue worth investigating.
These corner teeth, sometimes known as “fangs” or “eye teeth”, are crucial for both function and aesthetics. Understanding the difference between an impacted eye tooth vs canine tooth in terms of terminology is simple: they refer to the same teeth. These teeth are important for giving a pleasing, balanced smile, as well as for proper biting and chewing, preventing malocclusion (a bite problem caused by misaligned teeth).
According to the British Orthodontic Society (BOS), canine impacted tooth issues affect about 2-3% of the population and 85% of these are under the gum in the roof of the mouth. If left untreated, an impacted canine can cause problems for your oral health and smile. But the reassuring news is that various treatment options are available in the UK to address impacted canine teeth effectively, with high success rates when diagnosed early.
Spotting the signs of impacted canine tooth problems early can make a significant difference in treatment outcomes. But in some cases, buried teeth don’t cause any symptoms at all, which is why regular dental check-ups and radiographic examinations are so important.
Often, you won’t see the tooth itself from the outside, but you might notice asymmetry in your smile or an incomplete dental arch. The real concern lies beneath the surface, where the impacted tooth may damage adjacent teeth, affect the enamel of neighbouring teeth, or push neighbouring teeth into the wrong position. This damage could include root resorption of nearby teeth.
Potential complications include cyst formation around the buried tooth. And if the area becomes infected, you might experience additional pain and swelling.
The exact cause of canine impaction isn’t always clear, but various factors can contribute to a canine becoming impacted.
Lack of space: The most common reason is insufficient room in the jaw or dental arch for the tooth to allow proper eruption into the correct position (arch length discrepancy).
Abnormal development: Issues with tooth development, dental problems, or jaw abnormalities can disrupt normal eruption patterns.
Missing guidance: A missing or unusually small front tooth doesn’t provide proper guidance for the canine as it tries to erupt.
Retained baby teeth: If a baby tooth stays in place for too long, it can obstruct the path of the permanent canine.
Genetic factors: If your parents had impacted canines, you might be more likely to experience the same issue.
Trauma or anomalies: Injury to the mouth or jaw can disrupt normal tooth development, and cysts or other developmental anomalies can interfere with proper eruption.
Dental professionals often refer to the “guidance theory”, which suggests that canines follow the root of the lateral incisor as they erupt. The lateral incisor is the “side” front tooth closest to the two front teeth (central incisors). The root of the lateral incisor is like a “track” that the canine tooth “follows” when it enters the mouth. When this guidance system doesn’t work properly, the canine can become stuck or come out in the wrong place.
With early detection, timely interception, and well-managed surgical and orthodontic treatment, impacted maxillary canines can be successfully guided into the dental arch. Success rates are encouraging, but the choice of treatment depends on various factors, including the patient’s age, the position of the canine, the space available for the canine tooth and patient preference.
If the baby canine tooth is removed before the age of 11, it helps the adult canine tooth come in properly in about 91% of cases. But this works best if the adult canine is positioned slightly behind (away from the middle of) the root of the side front tooth (lateral incisor). If the adult canine is positioned more towards the middle (in front of the lateral incisor root), then removing the baby tooth only helps in about 64% of cases.
In other words, early removal of the baby canine can often guide the adult tooth into its correct place, especially when the adult tooth isn’t already too far off course.
This is based on clinical studies showing better eruption success rates when removing the baby canine early, depending on the adult canine’s initial position relative to the adjacent tooth.
Early diagnosis of an impacted canine is crucial, as it can significantly influence treatment outcomes. The diagnostic process begins with a thorough clinical examination by your dentist or orthodontist.
During this consultation, your clinician will examine your mouth, looking for signs of impaction such as missing teeth, retained baby teeth, or unusual bulges in the gums. They’ll also assess the overall alignment of your teeth and jaw development.
The next step usually involves dental technology for dental imaging. An X-ray, often a panoramic X-ray (OPG or orthopantomogram), provides a broad view of your mouth and jaw, allowing the orthodontist to locate the position of the impacted canine. For complex cases, 3D scans and advanced radiographic imaging may be used for precise positioning.
A careful assessment by an experienced orthodontist is essential to understand your specific situation and determine the best treatment option for your individual needs. For this reason, a dentist may refer a patient to a qualified orthodontist for further assessment and treatment.
The treatment plan is highly individual and depends on factors such as the severity and position of the impaction, your age, overall dental health and the space available in your dental arch.
Sometimes, the best course of action is careful monitoring. If the impacted canine isn’t causing problems or symptoms, your orthodontist might recommend leaving it in place with regular check-ups and periodic radiographic monitoring to assess the tooth’s position.
This is often the preferred treatment and is generally considered the most desirable approach, particularly for children and teenagers. The process involves surgery to uncover the buried tooth, followed by orthodontic treatment to guide it into the correct position.
During surgery, the impacted tooth is exposed, and often a gold bracket and chain are attached. The chain is then connected to your braces, allowing your orthodontist to gently pull the tooth into alignment over time. Modern techniques may also use mini-implants for anchorage to provide stable points for applying force to erupt the impacted canine.
Extraction is typically a last resort, especially for crucial canine teeth. This tooth may need removal if it’s in a very poor position, severely compromised, ankylosed (fused to the jawbone), or causing significant problems with adjacent teeth. While extraction solves the immediate problem, it does leave a gap that may need addressing with prosthetic options such as a partial denture, bridge, or dental implant.
Transplantation is considered a rare treatment option and generally has a lower success rate than other treatment options. It’s only considered in certain cases where surgical exposure and orthodontic treatment aren’t suitable.
If surgical intervention is required for your canine impacted tooth surgery, it’s almost always performed as a day procedure. Most patients undergo general anaesthesia, often combined with a local anaesthetic to numb the area and minimise discomfort.
During the surgical procedure, the surgeon makes a careful incision and lifts the gum to uncover the impacted tooth. Sometimes, removing a small portion of the surrounding bone is necessary. Once exposed, a gold bracket and chain are typically bonded to the tooth’s surface and connected to your existing brace. Gauze may be placed to control bleeding during the procedure.
How long does impacted canine surgery take? The surgical procedure typically lasts a few hours, including anaesthesia and recovery time. Following surgery, orthodontic treatment continues, with regular adjustments to gently pull the tooth into its correct position.
Recovery from canine impacted tooth surgery is generally straightforward, with most patients returning to normal activities within a few days.
Pain management: You may feel sore for a few days and the area may feel numb initially. Simple painkillers like paracetamol usually provide adequate relief.
Diet recommendations: Stick to a soft, cool diet initially. Most patients can return to normal eating after a few days.
Oral hygiene: Continue brushing with a soft toothbrush around the operation site. Rinse with warm salt water as recommended.
Wound care: Dissolvable stitches will disappear naturally as healing progresses, typically within 1-2 weeks.
You’ll have a follow-up appointment 1-2 weeks after surgery. If a bracket and chain were placed, your orthodontist will connect the chain to your braces to begin tooth movement. The orthodontic realignment process typically takes several months, often 6 months to a year, depending on the tooth’s starting position.
The active repositioning with braces can take at least 6 months to a year, depending on the tooth’s starting position. However, moving an impacted canine can be a very slow process, often taking more than 2 years for completion.
The entire process, including both surgical exposure and orthodontic guidance phases, usually takes between 12 and 24 months, but can extend beyond 2 years. Your orthodontist will provide a personalised timeline based on your specific case.
The cost of treating an impacted canine tooth varies considerably depending on case complexity, chosen treatment, and whether you receive private treatment.
Surgical exposure involves both surgical fees and ongoing orthodontic costs. Private treatment costs differ significantly from NHS treatment, where eligibility criteria apply. The best way to get an accurate quote is through consultation with an orthodontist who can assess your specific case and provide detailed cost information.
For those seeking expert care in London, at Hampstead Orthodontic Practice we offer interest-free payment plans with flexible monthly or quarterly payment options over 24 months.
Addressing an impacted canine tooth is important for both achieving a confident, well-aligned smile and preventing potential problems with other teeth. Effective and personalised treatment options are readily available here in the UK, with excellent success rates when diagnosed early.
A comprehensive assessment by a specialist orthodontist is the essential first step to understanding your unique situation and determining the best path forward. They’ll work with you to develop a treatment plan that fits your needs and goals.
If you’re concerned about a potential impacted canine tooth, or if your dentist has mentioned one, contact Hampstead Orthodontic Practice to book a FREE consultation with our experienced orthodontists. We can provide a thorough assessment and discuss the most appropriate treatment plan for you.
The entire treatment process varies significantly from case to case. Typically, the process, including both surgical exposure and orthodontic guidance phases, takes between 12 and 24 months. However, moving an impacted canine can be a very slow process, often requiring more than 2 years for treatment completion. Your orthodontist will provide a personalised timeline.
While early detection and treatment during childhood and adolescence (around ages 7-13) are crucial for simplifying the process and improving success rates, there isn’t an absolute age limit. However, the older a patient gets, there’s a possibility that the impacted canine tooth may not erupt normally even if enough space is created. Your age is a factor considered when determining treatment options.
If an impacted canine is left untreated, several oral health problems can develop:
Surgical exposure and orthodontic treatment generally work well when managed by experienced specialists working as a team. However, in rare cases, the buried tooth may be fused to the jawbone (ankylosed) and won’t move, requiring extraction. Transplantation has lower success rates than other treatment options and is rarely considered.
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