An impacted tooth is a tooth that is in such a position in the jaw that it is unable to erupt.  Wisdom teeth are the most common teeth to be impacted.  However upper canine (maxillary eye teeth) are also commonly impacted.

Impacted canines need to be treated because they can cause damage to adjacent teeth.  They can be in contact with the roots of adjacent teeth, causing resorption of the roots.  This is often not visible on x-rays until after they have been treated. 

The untreated impacted canine can also form cysts (a fluid-filled sac) around the unerupted crown.  This can destroy surrounding structures such as the jaw bone or roots of adjacent teeth. 

There are two treatment options for impacted canines.

• Surgical removal of the impacted canine by an oral and maxillofacial surgeon.
• Surgical exposure of the impacted canine by and oral and maxillofacial surgeon and orthodontic extrusion into the dental arch by and orthodontist.

The best option for each individual will be assessed by an orthodontist and an oral and maxillofacial surgeon.  Options available to each individual will be dependant on the position of the impacted tooth, compliance of the patient in undergoing the treatment, and the position of the rest of the teeth in the dental arch.  However if possible the best option is to surgically expose the impacted canine then orthodontically extrude it.

The maxillary canine is a major support for the inside cheek & nasal rim. Loss of the canine accentuates the appearance of a flattened upper lip. One sided (unilateral) canine loss can lead to considerable mid-facial asymmetry, as well as an off-centre position of the maxillary dental midline.

x-rays pre-treatment and 10 months post treatment

Treatment series showing… 1. Presence of primary (deciduous canine) with
2. Exposure of palatal canine & presence of orthodontic traction chain and elastic

(baby canine removed), and

3. Formal orthodontic positioning of permanent canine into arch.
Further orthodontic fine-tuning occurs after extrusion.

13 YEAR OLD FEMALE WITH PALATALLY IMPACTED UPPER CANINE

Progressive OPGs showing change of palatal canine position utilising gold chain.

Progressive photos showing change of palatal canine position utilising gold chain. Further orthodontic treatment is required to align adjacent teeth, as well as specifically rotate, & stabilise the canine tooth into a perfect arch position. Overall orthodontic treatment length can approach 2-3 years; a substantial proportion of which is dedicated to treatment of the impacted canine.

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