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Do you have a small canine? Maybe it is still a baby tooth.

The prevalence of impacted upper canines is around a 0.92% to 3.58%, being more common among females. Most of impacted canines (85%) are “sleeping” inside the palate.

We orthodontists consider that a tooth is impacted when it is partially or completely lodged inside the oral mucosa 2 years beyond their expected eruption time.

The most frequent impacted teeth and are the last to erupt are the “wisdom teeth”. They erupt at 18 years of age and the upper canines at 12 years of age.

 

What can make you suspect that you may have a canine inside your bone?

  1. AGE: Upper canines erupt at 13 years in boys and 12 in girls. Which means that if beyond, 15 years for boys and y 14 years of age for girls the permanent canines has not erupted, it would be advisable to take radiographs.
  2. TIME OF ERUPTION: Once the baby tooth has fallen off, the permanent tooth has to erupt at about 4 months
  3. PALPATION OF THE CANINE BULGE: As they slowly erupt from the bone until they come to place, the “bulge” under the lip and in the gums can be felt which indicates the presence of the upper canines. They are palpable 2-3 years prior to eruption. (between 9 to 12 years)
  4. COMPARISON WITH THE OPPOSITE CANINE: If there is a difference of appearance of 6 months between right and left canine, it would be advisable to have a panoramic x-ray taken.

And if I suspect something, what do I do?

The first thing is to have a panoramic x-ray done to see what is happening, maybe a cyst is present which is preventing the canine from erupting or maybe there is excessive crowding that may be impeding the canine from its correct position for example

In our clinic we carry out panoramic x-ray as control to see what is occurring from 8 to 9 years of age to assess the canine position or to see whatever pathology that may be present. We always have a panoramic x-ray taken at the first appointment irregardless of age.

Once an impacted canine is detected, it is necessary to have a study with a dental CAT scan. With this visual aid we will be able to visualize the impacted teeth (even if they are in bone) in 3D. With this software we can eliminate the bone thus seeing:

  1. The inclination
  2. The rotation
  3. The height
  4. The proximity to the midline of the mouth
  5. The contact with the roots of the other teeth

That way we can exactly know where they are located and what type of movement is necessary in order to create a path for the impacted tooth to reach correctly into the arch and with the rest of the teeth

Once located can they always be incorporated into its place?

The majority of the time they have a favorable position and they can be brought in its place with the rest of the teeth.

Although not always and depending on its location (example, the higher they are positioned, the harder their traction), the bite, the patient’s age, the absence or not of other teeth surrounding the area…we can say:

  1. No treatment, risks should be assessed regarding root resorption of adjacent teeth (example: lateral incisors), cyst formation,…
  2. Surgical exposure and orthodontic traction no doubt that there is no better substitute for natural teeth. So that the teeth comes out soon, to function properly and to have a stupendous smile, detailed planning of the route these teeth are to take and their position with the neighboring teeth which eventually would act as support in bringing the impacted canines to place.
  3. Extraction of an impacted tooth, there may be situations which after evaluating the position of the tooth that has to be brought to place, (example: positioned high), the age of the patient, (The higher the age, the more chances of anquilosis, which is to say, fusion of the root to the bone thus rendering it immobile), the bite of the patient, etc.…extraction may be the best option.

If you would want a complementary check-up to see if you may have a canine impacted into the palate or not, and what the best treatment approach to the case, you please call for a free clinical appointment at 952 77 77 47

Continued on part 2

 

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