Canine teeth are the sharp, pointy teeth that are located between the incisors and the premolars. An impacted canine means the tooth has only grown partially through the gums and have not yet erupted into the regular position, even after the normal eruption period. The canine tooth is a critical tooth in the dental arch and plays an important role in your “bite”. The canine teeth are very strong biting teeth because they have the longest roots of any human teeth. They are designed to be the first teeth that touch when your jaws close together so they guide the rest of the teeth into the proper bite. It is also important for aesthetic reasons as it is a front tooth, and can be seen during talking or smiling.
What are the causes of impacted canine?
Impacted canines can result from a genetic factor (means that the child gets this condition from the parents), or an environmental factor (means that the tooth did not erupt due to some obstacles present in its eruption path). Also, the canine (especially the upper ones) is the tooth that gets impacted most easily as it has a longest eruption path amongst all teeth. It starts forming somewhere below the eye, and slowly descends and erupts into the mouth. Therefore, in such a long distance, there may be a lot of things that can go wrong for the tooth to erupt.
The environmental factors that can lead to an impacted canine are:
- the tooth may be growing at an odd angle
- overcrowding – which means that the teeth is relatively bigger than the mouth. This leads to inadequate space for the mouth to allow all the normal amount of teeth to erupt in a nicely aligned fashion.
- The milk tooth did not fall off in time for the permanent tooth to erupt
- The lateral inicisor has a short root or is missing
Genetic factors usually lead to bilateral impaction of the tooth (impacted canines on both sides), and is more prevalent in females.
Sometimes, there will be no symptoms at all even when the tooth fails to erupt as it does not apply pressure or grow into another structure in the face. However, sometimes it does. The symptoms may range from mild to severe, and may be as described below:
1. An Opening In Between the Teeth
Before a tooth comes in, the teeth create a space for the incoming tooth. When an impacted canine doesn’t come in all the way, the space is left open. This can be a problem, because it is easy for food to get stuck in the crevice and go unnoticed. Sharp food can pierce through the tender gum and cause a cut, which can become swollen and infected.
2. Crooked Teeth
An impacted tooth can grow at an angle toward the other teeth. When this happens, the tip of the tooth pushes toward the root of the next tooth (as it is still embedded inside the gums) , and that tooth is forced to push against another tooth. A domino effect is created that can cause all of the teeth to be crooked.
When a canine tooth is impacted, it is also hidden. Therefore, the impacted tooth will be overlooked during everyday brushing. A lack of dental hygiene in the area can cause the canine tooth to decay. The decay can spread to neighboring teeth if it is not taken care of immediately.
An impacted canine puts pressure on surrounding nerves and teeth. The result is exquisite pain. It can become painful to chew, as well as to open and close the mouth.
5. Formation of cyst or tumor
There are a few types of cyst that are often associated with unerupted teeth, and most of them can cause resorption of the surrounding alveolar bone, when this happens, the alveolar bonne will get thinner and thinner, and eventually lead to pathological fracture. Which means that the alveolar bone will fracture when a mild pressure is applied on it, or even when normal pressure is applied.
6. Resorption of the Adjacent Tooth’s Root
Due to the pressure that is applied on the root of the adjacent tooth (usually the lateral incisor), it can become resorped, and if left untreated, the tooth can become loose and will shed.
The older the patient, the more likely an impacted canine will not erupt by nature’s forces alone even if the space is available for the tooth to fit in the dental arch. The American Association of Orthodontists recommends that a panorex screening x-ray along with a dental examination be performed on all dental patients at around the age of 7 years to count the teeth and determine if there are problems with eruption of the adult teeth. It is important to determine whether all the adult teeth are present or are some adult teeth missing. Treating such a problem may involve an orthodontist placing braces to open spaces to allow for proper eruption of the adult teeth. Treatment may also require a referral to an oral and maxillofacial surgeon for extraction of over retained baby teeth and/or selected adult teeth that are blocking the eruption of the all-important canine.