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Introduction
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Consultant maxillofacial surgeons deal with the diagnosis and surgery
of all dental impactions, including canine teeth. They maintain a close liaison
with your dentist or orthodontist.
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The Problem
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The canines, or eye teeth normally erupt from the upper jaw between
the ages of 11 and 13 years. They can usually be felt as lumps on the outside
of the gum just before they erupt. Sometimes one or both canines develop in the
wrong position. They can go across the roof of the mouth and become stuck
against the roots of other teeth. If the next tooth in front, the lateral
incisor, is missing or unusually shaped, this can also lead to the same
problem.
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What are the signs that a canine is in the wrong
position?
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The baby tooth may not fall out or loosen between 11 - 13 years and
the patient complains about the appearance. When the baby tooth is lost, a gap
is created which some patients do not like.
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What happens if the problem is ignored?
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The canine tooth often remains buried or may grow behind the other
teeth in the roof of the mouth. The buried canine may damage the adjacent teeth
by eating away or resorbing part of their roots in an effort to find a path
into the mouth. There may also be a gap if the baby canine has been lost.
Sometimes a cyst can form around the crown of the buried tooth and push other
teeth out of position.
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What happens if I have this problem ?
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Your Dentist will usually diagnose the problem by feeling for the
canine and taking x-rays to check its position. He or she will refer you to an
Orthodontist or Maxillofacial Surgeon for an opinion on the best ways of
handling the problem. Both specialists may be involved.
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What can be done about it?
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Accept and do nothing
If the buried tooth has not damaged the adjacent teeth, is not causing symptoms
and the dental appearance is good then no treatment may be necessary, apart
from review with x-rays, by the Dentist.
Remove the buried tooth
If the buried tooth is in a poor position, or shows signs of causing problems,
this may be the treatment of choice. This involves a minor operation. A false
tooth may be needed if there is a gap where the canine should have been.
Expose the buried tooth
This consists of a small operation, usually under general anaesthesia, to
remove bone and gum over the crown of the tooth and expose it to the mouth. A
dressing may be placed and held with stitches which are removed after two to
three weeks. Orthodontic treatment to align the tooth then starts. Other teeth
may need to be extracted to give enough space for the canine. This option can
only be carried out if the canine is suitable for orthodontic treatment and the
patient is prepared to wear an orthodontic fixed appliance for at least two
years.
Transplantation
If the buried canine is in a position where exposure and orthodontic treatment
is not possible but there is adequate space between the other teeth,
transplantation may be considered. It consists of removing the baby tooth if
present, removing the canine and replacing it as carefully as possible in the
correct position. It is then splinted for two to three weeks. The success rate
is variable and this approach is only chosen if there is no other choice.
If you have any questions or concerns, please contact your consultant
maxillofacial surgeon.
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