Exposure of Impacted Canines

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  • General Description
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  • FAQ: Frequently Asked Questions
  • Postoperative Instructions: ENGLISH
  • Postoperative Instructions: SPANISH: las Instrucciones


Certain are impacted and are important to retain in the mouth for cosmetic and functional reasons. One such tooth that commonly becomes impacted or unerupted is the upper canine or “eye tooth”. The second most common tooth to have this problem is the second molar. Keep an eye on both these teeth because they should progressively start to erupt and continue to erupt around the age of 11 years. Wisdom teeth or third molars are often impacted but these are seldom important in retaining because there is not usually enough space in the arch to accommodate these teeth.

The eye or canine tooth is important to retain in most cases. The orthodontist will make special arrangements to have enough space for this tooth to erupt. Sometimes the orthodontist will request the extraction of an upper bicuspid or premolar (the tooth immediately behind the canine tooth) to make enough room for it. In this procedure, Dr. Heffez opens up the gum, removes bone and sticks or bonds a special orthodontic bracket on the tooth. This bracket has a chain on it often called a gold chain because of its color. It is not, however, gold. The orthodontist then pulls on the chain slowly to pull the tooth into the arch. This is NOT a painful procedure although it may sound painful. It may take a few months to a year to get the tooth into the right place. The ability to slowly extrude or pull the tooth into the arch depends on the length of the canine root, the position of the tooth, your age, and the space between the tooth and the bone. Dr. Heffez will examine you and tell you more about your impacted tooth.


No. Usually the orthodontist will remove it when it gets close to the surface and replace it with one of their own brackets.

Yes. It is very common to perform this procedure.

It is possible that the tooth will be unable to be extruded or erupted into the arch because the tooth is stuck to the bone (ankylosis). In this case, Dr. Heffez may try to loosen its bony attachment and or lift it surgically into the right position. This rarely occurs in the younger patient. Sometimes, the tooth will bump into the incisor root or premolar preventing its full eruption.

If the bonding of the bracket is incomplete or the surface of the tooth is very calcified, the bonding will de-cement under a lot of force. Sometimes the tooth is so close to the surface and the orthodontist will only have to re-bond a bracket.

Rarely, when the tooth is deep and this occurs, it will require another attachment to be placed. This would require another surgical procedure.

If you feel your child would be unnerved with injection of local anesthetic (numbing agent) or the noise of a drill or length of the procedure, you may choose to have Dr. Heffez provided INTRAVENOUS ANESTHESIA to calm his fears.

Avoid brushing the bracket or chain as you may displace it. If there is food caught up on it simply rinse your mouth with water.

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