Impacted Canine Surgery

To understand impacted canine surgery, it’s important to first understand what it means to have an impacted canine.

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Impacted Canine Surgery

What is an Impacted Tooth? 

It is general dental information that canines have one of the lengthiest roots, and by the time a person hits the age of 13, these teeth are meant to ‘erupt’ and set into place. An impacted canine is one that is stuck or blocked and cannot erupt properly, affecting the overall functionality of the mouth. 

What are Wisdom Teeth? 

Most prominently, patients suffer from third molar teeth being impacted. These are commonly known as wisdom teeth. 

Wisdom teeth get blocked in the jaw and can cause severely painful infections and other problems. These teeth are considered useless as they don’t serve a purpose; thus, they are typically extracted as soon as they start developing problems. 

Meanwhile, the ‘upper eye tooth’ or maxillary cuspid is second on the list of teeth that are commonly impacted. Due to their design, they are the first set of teeth to touch when our jaws are closed, helping the other teeth find their place when the mouth is shut.

Therefore, they play a critical role in helping humans bite, making their position in the dental arch more important than the others. 

Steps to Follow When You Have Impacted Cuspid Teeth

When the maxillary cuspid (or canine) erupts around age thirteen, space previously left between the top front teeth is closed tighter together. 

However, once erupted, we do all that is necessary to ensure that the cuspid tooth erupts into its designated place within the dental arch. 

Dentists resort to several practices to help erupt impacted teeth in both the lower and upper jaw, but these techniques are most commonly used to erupt the maxillary canine. Roughly sixty percent of impacted cuspid teeth are found on the roof (formally known as the palatal side) of the mouth. And the other impacted maxillary cuspid teeth are located at the center of the auxiliary bone. 

Still, they are trapped in a raised position high above the adjacent teeth or towards the facial side of the dental arch.  

If the patient is older, there is less chance of the impacted canine erupting naturally, even if there is space in the dental arch for it to fit in. 

Furthermore, the American Association of Orthodontists has recommended that patients approximately seven years old go through panorex screening x-rays and dental examinations to determine if they face any issues with the eruption of their adult teeth. 

It is vital to know whether the child has all their adult teeth or some are missing. This will help pinpoint any unusual growths or extra teeth that could potentially block the eruption of the maxillary cuspid tooth. 

The dentist will also need to see if there is ample space available for the ‘upper eye tooth’ to erupt, as overcrowding or the lack of space can cause issues. 

At this point, a hygienist or general dentist becomes involved; they have to determine whether you have an impacted canine or not. If they notice any concerns, they will refer the patient to an orthodontist. 

To treat potential impacted upper-eye teeth, the orthodontist may place braces so that there is enough space for your adult teeth to erupt. 

Another treatment plan may require an oral surgeon extracting adult teeth and/or over-retained baby teeth that are making it hard for the cuspid teeth to erupt correctly. 

Any supernumerary (extra) teeth or any unusual growths blocking normal eruption of adult teeth will also have to be removed by an oral surgeon. 

Once the eruption path is successfully cleared up – and the space required in the dental arch is achieved by the time the patient is eleven or twelve – the impacted cuspid tooth will likely come forth by itself. 

Moreover, if the patient is past the age of fourteen, it is unlikely the impacted canine will erupt naturally, even with the space created in the dental arch. 

Remember that patients over forty have a very low chance of an eruption. The impacted tooth may remain stuck no matter what the oral surgeon or orthodontist does to help the situation. 

In these cases, the impacted upper eyetooth will need to be extracted, and either a fixed bridge or a dental implant with a crown will be required to replace the tooth in the dental arch.

If the impacted tooth does not erupt by itself, the oral surgeon and orthodontist must perform procedures to help. 

Each case is unique and should be examined individually; however, the treatment usually involves both the orthodontist and oral surgeon collaborating to resolve the issue. 

Usually, the treatment plan will include the orthodontist placing braces on the patient’s teeth. This will create space for the impacted tooth to move to its expected position all by itself. 

Dentists leave the baby canine untouched if it has not come out yet until the required space is created. Once it is, the oral surgeon will expose and bracket the impacted canine. It is a simple procedure performed by surgeons in their offices. 

During the impacted canine surgery, the gum that conceals the impacted eye tooth will be lifted to expose the tooth. If the baby tooth is still there, it will also be removed at that time.

After the impacted tooth has been exposed, the oral surgeon ties the exposed tooth with an orthodontic bracket. This bracket has a small gold chain attached to it. 

The surgeon will then guide this chain to where the orthodontic archwire is, attaching it temporarily. In some cases, the oral surgeon may uncover the exposed impacted canine by:

  • Making a ‘window’ to reveal the impacted tooth through the gum (which is sometimes on the palatal side) 
  • Using sutures to pull the gum above the tooth 

Usually, the gum returns to its original place and is sutured up, while the chain is visible through a tiny hole made in the gum. 

The patient is then required to revisit the orthodontist within fourteen days. They will attach a rubber band to the chain so that there is a subtle pulling force created to aid the eruption of the impacted tooth. 

This procedure will help move the impacted tooth to its proper position. The whole process is prolonged and controlled, so it usually takes about a year to complete. 

Keep in mind that the goal of this process is to aid the tooth’s eruption process, not extraction!

Once the tooth has moved to its final place in the dental arch, the dentist will evaluate the gum surrounding it to make sure it is healthy enough to last a lifetime worth of brushing and chewing. 

Sometimes, in cases that involve the impacted tooth being moved a long way down, minor surgery may be required on the gum so that the surgeon can bulk up the gum tissue on top of the erupted tooth. This is done to avoid issues with standard tooth functionality. 

These procedures can be performed on impacted teeth located anywhere in the mouth. Usually, the upper eye teeth are the ones that get affected the most. 

And if they are both impacted at the same time, your orthodontist will create the space needed in your dental arch on both impacted teeth together. 

Once the orthodontist gives the green signal, the oral surgeon will use the required methods to expose the impacted teeth and bracket them during the same appointment, meaning that you will only have to go through the impacted canine surgery once. 

Keep in mind that the bicuspid and anterior teeth (cuspids and incisors) are smaller, having singular roots, making it easier for them to erupt even if they are impacted. 

On the other hand, the posterior molar teeth are bigger, having multiple roots, making it more challenging to erupt. 

It is a lot more complicated for an orthodontist to operate on impacted molar teeth because they are located at the back of the mouth. Studies have shown that with early recognition of impacted canines, the treatment should begin with haste.

As soon as a hygienist or general dentist identifies potential eruption problems, patients should see an orthodontist to be evaluated. Sometimes, patients are even referred to an oral surgeon before they get braces. 

The surgical process used to expose and bracket the impacted tooth is relatively straightforward and is conducted at the oral surgeon’s office. 

The process begins with the application of local anesthesia and laughing gas. If the patient expresses their desire to be asleep during the surgery, general anesthesia/IV sedation can also be used. 

However, usually, this is not necessary. The surgery usually takes about 75 minutes if only one tooth is being operated on, and it takes collectively 105 minutes for both sides. 

Additionally, if the surgery requires only exposing the impacted tooth but not bracketing it, the duration will be reduced by an hour. 

Your pre-operative consultation will consist of the doctor discussing all potential issues with you in complete detail. Check out our list of Post-operative Instructions under the surgical instructions heading on our website to go over any details.

Furthermore, you may experience a little bit of blood after surgery. You may also experience some discomfort after the operation, for which most patients depend on Advil or Tylenol. Although under no circumstances should you prescribe yourself painkillers or other medication, always consult a general physician before consuming one.

By the second or third day post-surgery, you may not need medication at all. Some swelling can occur due to the surgeon holding your lip up to get better visualization. You can use ice packs on your lip to decrease this puffiness. 

But that is the extent of the physical pain; it is uncommon for extensive bruising to occur. 

You would be recommended to eat soft and bland foods after surgery; however, you can go back to your regular diet whenever you feel like you can chew without discomfort. 

Dentists advise against eating sharp food items such as chips or crackers, as the surgical site is susceptible to irrigation if the wound is jabbed during the initial healing process. You will have a post-op check with your doctors after about a week so that they may evaluate your healing process while making sure that you have maintained oral hygiene. 

It is advised that you schedule an appointment with your orthodontist in 2 weeks so that they can help move the eruption process along. To do this, your orthodontist will apply a rubber band to the chain attached to your tooth. 

Once you’re done with the procedure, remember that your doctor will be available at their office if any issue arises. You can also beep them after office hours if necessary.

Our maxillofacial surgeons and other dental specialists are versed painless extractions.

You no longer have to let your tooth pain control you as St. Luke’s OMS offers same-day tooth extractions! We will make sure to listen to your concerns carefully and examine your teeth meticulously. 

Also, we offer around-the-clock care; patients can call or walk in anytime in the case of emergencies. 

St. Luke’s OMS is a 24-hour oral surgery emergency center. One of the leading oral surgery practices in Lehigh Valley, you can trust us to take great care of all your dental surgery needs. Call us at 610-865-8077 or contact us through our website to schedule an appointment. You can also fill out the form below with any further questions or concerns you may have regarding our operations. We have four separate locations throughout Lehigh County, including: Allentown, Bethlehem, Easton, and Stroudsburg.

Office Locations

Bethlehem, PA
Allentown, PA
Easton, PA
Stroudsburg, PA


We love getting feedback from our patients! If you’re still undecided about whether or not you can trust St. Luke’s OMS to handle your oral surgery needs, than please feel free to see what others are saying on our testimonials page.

I can’t say enough good things about Dr Saunders and the entire staff at OMS! The level of care is superior as is the genuine care for your overall well-being. The staff is always available to answer any of your questions and concerns and all of their locations are equally superb!

Called made an appointment for a wisdom tooth extraction. Was in and out within a half hour. Unbelievable service and amazing pricing. Wouldn’t go anywhere else. Thank you to everyone there that made this painless.

I have had extractions and one implant so far with St. Luke’s OMS Bethlehem and highly recommend them. Dr. Isaac and her team have always been stellar. Gentle, caring, just a top notch group. So grateful to be a patient of the practice and Dr. Isaac.
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Our team at St. Luke’s OMS makes themselves available 24 hours for oral surgery emergencies. That is why we are the leading Lehigh Valley oral Surgery Practice! If you have an issue that is not during the time of office hours, call us at 610-865-8077 and leave a message for our answering service. We will be able to evaluate your emergency needs and direct you as needed.