Identifying and Treating Impacted Canines

Dr Diane Tay and specialist orthodontist Dr Andrew Chang discuss an interesting topic for dentists on impacted canines in children and early teens.

0:34 There can be a number of implications if impacted canines are not picked up early. Main causes of impacted canines include crowding and genetics.

2:17 A simple definition of an impacted canine is a canine not sitting in the right position and becoming 'stuck'. Affecting the eruption path. If an OPG is taken and there appears to be overlapping.

3:00 Clinical signs to consider include, average age (9-10yrs), feeling of canines, OPG results, flaring of canines, crowding, lateral spacing, assymetrical exfoliation, positions of teeth appropriate for age and a primary canine still present. Aim is to normalise path of eruption.

11:52 Depending on severity of case early interceptive is a way to present surgery and lead to spontaneous eruption. Age has a big impact on successful results.

13:40 Best age to intervene is between 7-9 years. Start with an orthodontic assessment as the more simple orthodontic treatments work best in younger people.

15:25 Dr Chang discusses two patients. A 9-10 year old boy who had a canine that was almost horizontal and was treated in 7 months. Then a teenage girl who had a 4 year treatment plan.

16:55 When impacted teeth are not treated early there can be bone defects and full root development, that will effect spontaneous eruption. Correct timing is critical.

18:55 To manage an impacted canine we need to assess the case and the severity of the impacted tooth. Consider age and cooperation of child, angulation of tooth, collusion of teeth then develop a treatment plan in conjunction with an orthodontist. Surgery and extraction may be required. New treatment options like orthodontic micro screws can be considered.

23:34 Monitoring patients needs to be kept to a minimum to avoid missing the opportunity for less complex treatments. If unsure, you can always check. Irregular dental attendees should always be referred.

Dr Diane Tay and Dr Andrew Chang look forward to their next discussion.