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This information is designed to help your understanding of the condition where a canine tooth fails to erupt normally, and what treatments are available to help remedy it.

The problem

The upper canine, or “eye tooth”, normally erupts into the mouth between the ages of 11 and 13. Sometimes teeth can develop in an abnormal position and the upper canine is the most common tooth to be affected in this way. Often they will lie across the roof of the mouth behind the front teeth.

Occasionally the premolar, incisor or molar teeth can fail to erupt.

Why is treatment required?

The upper canine has a long root making it a strong tooth and is an important tooth both for biting, and in the development of a normal smile.

Sometimes they may be left alone and will remain un-erupted for many years, possibly a whole lifetime. They can, however, damage the roots of other front teeth or push them out of position. They can interfere with the orthodontic movement of other teeth. More rarely cysts can develop around them.

Treatment is almost always provided as part of on-going orthodontic treatment to help the teeth to erupt normally into the mouth.

What does the treatment involve?

  • Helping the tooth to erupt into the mouth involves a relatively minor surgical procedure.
  • The procedure can be carried out under local anaesthesia (injection in the gum to numb the area), with or without intravenous sedation (injection in the arm or hand to reduce anxiety), or under general anaesthetic (completely asleep in a hospital).

Usually we perform these procedures with intravenous sedation, but an appointment is made initially for a consultation to discuss the options, and allow you to choose the method best suited to you.

Depending on the position of an un-erupted tooth, there are, generally speaking, two techniques that we use for exposure.

  1. Moving a flap of gum, and taking away a small piece of bone so that the tooth is showing through.
  2. Moving a flap of gum, and taking away a small piece of bone, and then bonding a small chain onto the tooth. We then replace the gum in its original position. The orthodontist can then use the chain to pull the tooth gradually into the correct position. Pulling can usually begin a couple of weeks after surgery when healing is complete.

What are the after effects?

Following surgery there is usually very little swelling but there will be some soreness. This is normally taken care of with simple painkillers. It is not usually necessary to take antibiotics.