Nearly everyone has heard about impacted wisdom teeth, but what about impacted canines? It is a finding, usually first detected on an x-ray that dentists often see and must properly manage.
An impacted canine is an eye tooth that, instead of erupting normally into the mouth, remains embedded in the jaw bone. Why this happens is something of a mystery, but the existence of an impacted canine, though uncommon, is not rare.
When patients are informed of this condition, they justifiably want to know what it means, if it is a problem, and whether it needs to be treated. The answers to these questions can be complicated, but a few basic facts can shed some light on the subject and make decisions easier for the patient.
The canine is the cornerstone tooth of the human dentition. Some call it an eye tooth, but it is properly called a canine because, as the longest tooth in the mouth, it resembles the long tooth of a dog. Because of its strength and position, as well as the fact that it is near the front of the mouth and highly visible, it is one of the most important teeth. It therefore follows that if one or both of a patient's canine teeth remain impacted and fail to properly erupt into the mouth, it is a matter of concern to both the dentist and the patient.
Next to wisdom teeth, upper canines are the most commonly impacted teeth. They occur in about 1 out of 50 people, and twice as often in females as in males. They occur about half as often in the lower jaw as the upper. Of those who have impacted canines, about 1 out of 10 have them bilaterally—on both the left and right side.
Patients must be aware, however, that any retained impacted tooth should be regularly monitored in the future with periodic radiographs to make sure they don't develop cysts or other pathology.
The cause of impacted canines is not clear. Researchers have proposed numerous possible local, systemic, and genetic factors, but it is usually not possible to determine the causative factor in any given case.
Impacted canines are usually asymptomatic, so patients are nearly always unaware of their presence until their dentist informs them of it. Dentists can sometimes detect them clinically by a bulging in the jaw bone that these teeth can create. However, the definitive diagnosis is usually made by their appearance in radiographs.
Often, adult patients will have a space or a baby tooth where the impacted canine should be. Even if a baby tooth is still present, it likely will eventually resorb and fall out, leaving a space. Thus, the dentist will—perhaps after consulting with an orthodontist and an oral surgeon—want to sit down with these patients and help them make some important clinical decisions. There are several different ways to treat an impacted canine, any one of which can be the right one for a given patient. These include:
An impacted canine can present many clinical challenges, but there are several viable ways in which dental professionals can manage them. Patients who have been told that they have impacted canines are encouraged to discuss their options with their dentist and decide which one is best for them.