Short answer: In suitable cases, an impacted canine can be surgically exposed, have a small attachment bonded onto it, and then be pulled into the dental arch with orthodontic force. The position of the tooth is usually evaluated with three-dimensional imaging such as a CT scan. The duration varies. For teeth that cannot be pulled into place, there are alternatives such as monitoring, extraction or space closure.
An impacted canine is a canine (eye tooth) that has not been able to erupt into its place in the mouth and remains inside the jawbone or beneath the gum. In many cases, this tooth can be exposed surgically and guided into the dental arch with orthodontic force; however, it may not be possible to save every impacted canine with this method. The decision depends on the position of the tooth, its relationship with the neighboring teeth and the patient's age, and it is made after imaging.
Why do canine teeth stay impacted?
Canine teeth are among the last to erupt in the mouth and travel a long path through the bone. This long path is open to deviations. The main reasons for impaction can be listed as follows:
- Lack of space: If the jaw is not wide enough, the space reserved for the canine narrows and the tooth cannot find room to erupt.
- Late loss of the baby canine: If the primary canine does not fall out on time, the path of the permanent tooth can deviate.
- Position of neighboring teeth: A small or missing lateral incisor can affect the eruption path of the canine.
- Cysts, extra teeth or obstructing structures: Rarely, a formation inside the bone can block the path of the tooth.
- Hereditary tendency: Similar cases can occur within a family.
For the general causes and signs of impacted teeth, you can also take a look at our article on impacted teeth.
How is an impacted canine noticed?
An impacted canine usually produces no symptoms; for this reason it is noticed by chance at a routine exam or on X-rays taken before orthodontic treatment. Some signs may raise suspicion: you should see a dentist if the canine on the opposite side has already erupted while a baby tooth is still in place on the other side, if the position of the lateral incisors has been disturbed, or if you feel a hardness on the palate or gum.
Noticing it early offers a real advantage here. This is one of the reasons it is recommended that children have their first orthodontic check-up at an early age. For details, you can take a look at our article on the first orthodontic exam for children.
Why is 3D imaging important for diagnosis?
A panoramic X-ray shows the approximate location of the impacted tooth, but it may not be enough to tell exactly whether the tooth is closer to the palate or the cheek, or how close it comes to the roots of the neighboring teeth. A dental CT scan, which provides a three-dimensional image, clarifies this information. A CT scan is not needed for every patient; the dentist requests it in the cases they consider appropriate, weighing the radiation dose against the benefit. You can find detailed information about the method in our article on dental CT scans.
Three-dimensional imaging can also show whether there is resorption (loss of root structure) on the roots of the neighboring teeth. This finding can affect the treatment plan and even whether the tooth can be saved.
How is an impacted canine brought into place orthodontically?
The orthodontic traction process is usually teamwork and proceeds in several stages:
- Creating space: First, the space the canine will move into is prepared orthodontically in the dental arch. If there is no room, this area must be opened up before the tooth is pulled.
- Surgical exposure: The surgeon uncovers the gum and, if necessary, the bone over the tooth with a small procedure. The procedure is usually carried out under local anesthesia.
- Attaching an anchor: A small bracket or attachment is bonded onto the surface of the exposed tooth, and a thin chain or wire is tied to it.
- Controlled traction: With the chain connected to the orthodontic wire, the tooth is guided toward the mouth with gentle force over weeks and months.
- Final alignment: Once the tooth reaches the arch, its position, color and bite relationship are completed with fine adjustments.
For the general framework of surgical procedures, you can take a look at our article on oral, dental and jaw surgery.
How long does treatment take?
The duration varies considerably depending on how deep the tooth is in the bone, its direction and the patient's age. In simple cases the traction takes a few months, while with deeper or angled teeth it can exceed a year. For this reason, the total orthodontic treatment time cannot be stated precisely in advance; the dentist reviews the plan based on progress. For general information about braces and check-up intervals, you can look at our article on what orthodontics is.
What alternatives exist if traction fails or is not possible?
Not every impacted canine can be pulled into place. If the tooth is fused to the bone (ankylosis), it will not move; if the root position is very unfavorable or the risk of harming the neighboring teeth is high, the dentist may suggest a different route. The main options are as follows:
- Monitoring: Leaving the tooth where it is and monitoring it regularly if there are no symptoms and the risk is low.
- Extraction of the impacted tooth: Surgical extraction if it is damaging the neighboring teeth.
- Closing the space: Moving the neighboring teeth orthodontically into the gap.
- Prosthetic solution: After extraction, the gap can be filled with methods such as an implant or a bridge.
Which option is suitable is decided by evaluating the patient's age, the condition of the tooth and the patient's expectations together. For options to replace a missing tooth, our article on implant or bridge can guide you.
What happens if an impacted canine is not treated?
Not every impacted canine causes problems; some can stay in the bone for years without any symptoms. However, a canine that cannot take its place in the mouth can leave a gap in the dental arch, press on the root surface of the neighboring teeth and cause resorption, or set the stage for a cyst to form around it. Because canines play a role in facial and jaw balance and in guiding the bite during side-to-side movements, their absence can also affect the chewing pattern. For this reason, whenever an impacted canine is seen, it is important to make an informed decision about follow-up, even if nothing is going to be done.
What should the patient keep in mind during treatment?
After surgical exposure, a few days of tenderness and mild swelling may occur; you should follow the care and medication instructions recommended by your dentist. Because the chain or wire connected to the attachment stays on the tooth, it is important not to neglect cleaning in this area. Avoiding hard and sticky foods also prevents the attachment from coming off. If the attachment comes off or the chain pokes the palate, you should let the clinic know without wasting time, because it is important for the traction process to proceed without interruption.
In the first months of orthodontic traction, it can be hard to notice that the tooth is moving. This is normal; the movement happens slowly with gentle forces. The measurements your dentist takes at check-up appointments show the progress. After the traction is complete, you should also follow the retention phase to maintain the tooth's new position; you can find the details on our page about retainers after treatment.
Can clear aligners be used to bring an impacted canine into place?
Fixed attachments are usually needed for the first traction stage of the impacted tooth; clear aligners, on the other hand, can additionally be used to align the teeth or to create space. This approach may not be suitable for every case. For general information, you can look at our clear aligner treatment page.
For an exam in Ankara
If your child or you have a baby canine that fell out late, a permanent canine that has not erupted, or an impacted tooth seen on an X-ray, an evaluation can be carried out at our clinic in Çankaya Park Oran Ofis. To get appointment information, you can use our contact page.
Frequently asked questions
Is an impacted canine always extracted?
No. In suitable cases the tooth can be brought into place with surgical exposure and orthodontic traction. For teeth that cannot be pulled into place or that damage the neighboring teeth, options such as extraction or monitoring are considered.
Is a CT scan required for an impacted canine?
It is not required in every case. When a panoramic X-ray is not enough and the location of the tooth and its relationship with the neighboring roots need to be clarified, the dentist may request a CT scan.
How long does pulling an impacted canine into place take?
The duration varies with the depth and direction of the tooth and the patient's age. In some cases a few months are enough, while in others it can take more than a year. The exact duration is assessed by the dentist as treatment progresses.
Can an impacted canine be noticed in advance in children?
In most cases, yes. Regular orthodontic check-ups and X-rays taken when needed can show deviations in the eruption path of the canine at an early age, so early intervention options can be considered.