The upper canine tooth is the second most common tooth to become stuck beneath the gum line, a condition known as impaction. Correcting this situation requires a coordinated approach involving a specialist surgeon and an orthodontist to guide the tooth into its proper position. This article explains the process and the expected timeline for completing the treatment using braces.
What is an Impacted Canine Tooth
An impacted tooth is one that is blocked or unable to fully emerge through the gums and into the mouth within the normal developmental timeframe. Following the third molars (wisdom teeth), the upper jaw’s canine teeth are the most frequently impacted teeth. These teeth typically erupt between 11 and 13 years of age, making them the last of the front teeth to appear.
The canine is crucial for both aesthetics and function, helping to shape the smile and guide the bite. Impaction often occurs because of inadequate space in the dental arch, the premature loss or prolonged retention of a baby tooth, or the presence of extra teeth. Diagnosis involves a clinical examination combined with specialized X-rays, such as panoramic films or a three-dimensional cone-beam computed tomography (CBCT) scan, to pinpoint the exact location and orientation of the buried tooth.
The Treatment Process Surgical and Orthodontic Steps
Correcting an impacted canine is a collaborative effort between the orthodontist and an oral surgeon or periodontist. The initial phase involves the surgeon performing a procedure often called “exposure and bonding.” This surgery requires lifting the gum tissue to uncover the hidden tooth, sometimes removing a small amount of bone tissue covering the crown.
Once the tooth’s crown is visible, a small orthodontic attachment, usually a bracket with a fine gold chain, is cemented directly onto the surface. The surgeon then repositions the gum tissue, either leaving a small opening for the chain (open eruption) or closing the gum over the site (closed eruption) with the chain extending out and attached to the braces.
The second phase, orthodontic traction, begins shortly after the surgical site has healed, often within one to two weeks. The orthodontist uses the chain or wire attached to the bracket to apply a light, continuous pulling force, directed toward the correct position in the dental arch. This controlled force slowly guides the buried tooth out of the bone and through the gum tissue. The surrounding teeth, which are already fitted with braces, act as anchors to provide the necessary support for this movement.
Understanding the Timeline Factors Affecting Duration
The timeline for treating an impacted canine is highly individualized. The initial phase of moving the tooth from the bone into the dental arch, known as the eruptive phase, typically takes between six and twelve months. This period requires regular appointments for the orthodontist to gently adjust the tension on the chain, ensuring the tooth is moving along the correct path.
The most significant factor influencing this timeline is the tooth’s initial position and depth of impaction. Teeth positioned high in the jawbone or angled sharply require more time and more complex mechanics to move than those closer to the correct path. The patient’s age also plays a role, as younger patients often have less dense bone structure, which can facilitate faster tooth movement.
The overall time a patient wears braces includes the movement of the impacted canine, plus the time needed to create space and achieve final alignment of all the teeth. The total treatment time for a case involving an impacted canine typically ranges from 18 to 30 months. Consistency with appointments and maintaining excellent oral hygiene are also factors, as missed visits or broken brackets can lead to delays in the overall treatment plan.
Post-Treatment and Retention
Once the impacted canine has been successfully brought into the dental arch and fully aligned with the surrounding teeth, the active phase of treatment concludes. The full set of braces is removed, and the patient enters the retention phase, which is necessary for maintaining the new position of the moved teeth.
Retention is necessary because the tissues and bone surrounding the newly moved tooth need time to stabilize and solidify in their corrected location. The orthodontist will prescribe a retainer, which may be a removable clear tray or a thin wire bonded directly to the back surfaces of the teeth. This retainer helps prevent the canine from shifting back toward its original impacted position. Follow-up appointments are scheduled to monitor the stability of the canine and the overall bite, ensuring the long-term success of the treatment.