Short answer: A canine tooth that sticks out or sits high is one that erupts outside the dental arch, toward the lip side. The most common cause is lack of space; because the canine is among the last teeth to come in at the front, when it cannot find room it erupts from the outside. In treatment, space is created first, and then the tooth is aligned with braces or, in suitable cases, clear aligners. The method is determined at the exam.
It is quite common to notice when smiling that one of the canine teeth stands in front of the other teeth, near the gum and "up high." This situation, called canine tooth sticking out or a high canine tooth in everyday speech, is described in orthodontics as the canine erupting out of the dental arch sequence, mostly toward the lip side. In most cases the cause is lack of space and it can be corrected with orthodontic treatment. In this article, we match the everyday expressions with their medical equivalents and explain the causes, how it differs from an impacted canine and the treatment options.
Why does a canine tooth stick out or sit high?
The most common reason a canine tooth sticks out or sits high is that, at the time it erupts, there is not enough room for it in the dental arch. When the tooth cannot find space, it changes its path of eruption and comes into the mouth in front of the other teeth, at a higher level of the gum.
First, let us clarify the terms:
- Canine tooth (called "dog tooth" in Turkish): Its medical name is canine. Counting from the midline, it is the pointed tooth in third position on the right and left of each jaw.
- Canine sticking out / protruding: The tooth erupting toward the lip (vestibular) side. In orthodontics, this is described as a "buccally or labially positioned canine."
- Canine sitting high: The tooth looking as though it has not come down to the level of the neighboring teeth and has stayed in the upper part of the gum. This is mostly seen together with eruption on the outside.
Besides lack of space, the baby canine staying in the mouth for a long time, differences in the shape and size of neighboring teeth, hereditary jaw structure and individual differences in the direction of the tooth's eruption can also play a role. Which factor is in the foreground is evaluated with an exam and X-rays.
Lack of space and the order of eruption
The upper canines are among the last teeth to erupt in the front area; they generally come into the mouth around age 11-12. Because the incisors in front of them and the premolars behind them have already settled, if no space is left in the arch, the canine cannot fit in between.
You can think of this process as follows: the incisors and premolars have taken their places, and the gap between them has remained narrower than the width of the canine. In this case, the tooth heads in the direction where the bone offers the least resistance, that is, mostly outward and upward. As a result, the look of a high canine tooth appears.
Lack of space may not be limited to a single tooth and may be part of general crowding. You can find general information on this in our article on treating crowded teeth. An orthodontic check-up done at an early age can help anticipate the eruption direction of the canines and, if needed, plan measures to gain space.
How it differs from an impacted canine
A canine that sticks out or sits high has come into the mouth; an impacted canine, on the other hand, refers to a tooth that has stayed in the bone or gum and has not been able to erupt on its own. Although the two situations look close, the treatment approaches are different.
- Canine erupting on the outside: The tooth is visible in the mouth. The aim of treatment is to make room for it and align it within the arch.
- Impacted canine: The tooth is not visible, or only a small part of it can be felt. It is often positioned on the palate side. Treatment generally involves exposing the tooth with a small surgical procedure and pulling it into place with orthodontic force.
If the baby canine is still in the mouth after age 13-14 and the permanent tooth is not visible, an exam is recommended for the possibility of an impacted canine. We covered this topic in detail in our article on pulling an impacted canine tooth into place with orthodontics.
Treatment: creating space and aligning
When a canine sticks out, the basis of treatment is to create enough room in the arch for the tooth and then carry it into place in a controlled way. It is not possible to bring the tooth in without space being created.
The main methods that can be used to create space are as follows:
- Expanding the arch: Especially in children and teenagers of growing age, expanding narrow jaws with suitable appliances can gain space.
- Moving the teeth back: By moving the back teeth back in a controlled way, room can be opened toward the front.
- Minimal reduction between the teeth: This procedure, done in very small amounts on the tooth enamel (interproximal reduction), can provide room in mild and moderate lack of space.
- Tooth extraction: If the lack of space is marked, a planned tooth extraction may be needed.
After space has been created, the canine is brought down toward the arch and aligned with a bracket and wire system or, in suitable cases, with clear aligners. The answer to the frequently asked question of whether a canine can be corrected with braces is yes in most cases; the length varies with the amount of the lack of space, the age and the method applied, and it is determined at the exam.
Is tooth extraction needed?
Extraction is not needed for every canine that sticks out; the decision is made according to the amount of lack of space, the facial profile and the overall condition of the teeth. Mild and moderate lack of space can often be solved with non-extraction methods.
When extraction is required, it is generally not the canine itself but one of the premolars behind it that is chosen. The canine is a tooth that is important to preserve because of the length of its root, its position in the mouth and its role in guiding the jaw movements during chewing. For this reason, a "let's pull the protruding canine" approach is generally not preferred in orthodontics.
You can find in detail in which situations treatment with and without extraction is considered in our article on whether tooth extraction is needed in orthodontic treatment.
Can it be treated with clear aligners?
In some mild and moderate cases, a canine that sticks out can be aligned with clear aligners; however, if the tooth is very high and markedly outside, fixed wires or combined approaches may be more suitable. The decision on suitability is made after an exam and digital planning.
Canines are teeth that need more planning to move because of their long roots. At our clinic, clear aligner treatment is provided only with Invisalign. Thanks to small, tooth-colored attachment points bonded to the tooth and the digital treatment plan in Invisalign, bringing the canine down and rotating it can be planned in a controlled way. In some cases, elastics or auxiliary appliances may also be needed during part of the treatment.
We described the general workings of treating crowding with clear aligners on our page on treating crowding with clear aligners. Which method is suitable in your case is evaluated with an intraoral scan, X-rays and a clinical exam.
Is it right to wait while the canine sticks out?
In children whose tooth is still erupting, a short monitoring period may be appropriate, but once the permanent dentition is complete, a protruding canine is hardly expected to settle into place by itself. Waiting for a long time can also bring some risks with it.
- The gum and bone over a tooth standing on the outside can be thin; gum recession may be seen in this area over time.
- The irregular position can make brushing difficult and increase plaque buildup.
- Because the canine cannot guide the jaw movements, wear can be seen in the biting pattern and in the other teeth.
For this reason, early evaluation is useful in children and teenagers whose canine looks like it is sticking out, and planning at a suitable time is useful in adults.
An evaluation in Ankara
If you have noticed that your canine tooth or your child's canine tooth sits outside or high, the first step is an orthodontic exam aimed at seeing the position of the tooth and the space around it. At our clinic at Park Oran Ofis in Oran, Çankaya, Funda Pekyılmaz Sarıkaya, specialist orthodontist (Uzm. Dt.), evaluates with you, after taking the necessary records, the need to create space, the need for extraction and which of the fixed wire and clear aligner options is suitable. You can use our contact page for appointments and questions.
Frequently asked questions
When should a child whose canine sticks out see an orthodontist?
A check-up around age 10-12, the eruption period of the canines, is useful. If the tooth is erupting from the outside or the baby canine does not fall out for a long time, early evaluation is recommended. Measures to gain space can be planned during this period.
Can a canine that stays outside be corrected in adulthood?
Yes, in adults too, the canine can be moved into place with orthodontic treatment. Because growth is complete, the methods of creating space may differ and the duration may be longer. The suitable method is determined by the exam and X-rays.
Is having a protruding canine extracted a solution?
The canine is a tooth that is important to preserve because of its root length and its role in guiding jaw movements. If extraction is needed, one of the premolars behind it is generally chosen. The decision is made through orthodontic planning.
Can a canine that sits high lead to gum recession?
Because the gum and bone over a tooth positioned on the outside can be thin, gum recession may be seen over time in some people. The irregular position also makes cleaning more difficult. For this reason, planning treatment at a suitable time is recommended.
