Impacted Canine
Tooth Treatment
in Dallas–Fort Worth
The upper canine is the second most commonly impacted tooth — and one of the most important to save. DFWOMS’s board-certified oral surgeons work alongside your orthodontist to expose and guide impacted canines into their proper position, at our Irving, Mesquite, and Ennis locations.
A critical tooth that gets stuck
An impacted tooth is one that is “stuck” and unable to erupt into its proper position in the dental arch on its own. While impacted wisdom teeth are the most common, the upper canine (maxillary cuspid) is the second most frequently impacted tooth — and far more consequential to leave untreated.
The canine teeth play a critical role in your bite. They are designed to be the first teeth that make contact when your jaws close, guiding the rest of your teeth into proper alignment. They are also among the strongest, longest-rooted teeth in your mouth — built to last a lifetime. Every effort is made to bring an impacted canine into its correct position rather than extract it.
Why timing matters for impacted canines
Upper canines normally erupt around age 13, closing any remaining space between the upper front teeth. The earlier an impacted canine is identified, the better the chances of guiding it into place successfully — and the simpler the treatment.
The American Association of Orthodontists recommends that all dental patients receive a panoramic X-ray and dental examination around age 7 to count the developing teeth and identify any eruption problems early. The older the patient, the more likely an impacted canine will not erupt on its own — even with adequate space — making early screening essential for the best outcome.
Treatment of an impacted canine is a coordinated effort between an orthodontist and an oral surgeon. The orthodontist opens the space needed in the arch using braces, while the oral surgeon surgically exposes the tooth and bonds an orthodontic bracket to it. Together, the tooth is guided into its proper position over time.
How impacted canines are treated
The right treatment plan depends on the patient’s age, the position of the impacted tooth, and the available space in the arch. Treatment typically involves one or more of the following:
What to expect: exposure & bracketing
The most common surgical treatment is the exposure and bracketing of the impacted canine — a straightforward outpatient procedure performed at our office. Here is what the process looks like from start to finish:
Before surgery, your orthodontist places braces and opens the space needed in the dental arch for the canine to be guided into. This phase may take several months and is essential to the success of the overall treatment. Once space is ready, you are referred to our office for the surgical step.
The procedure is performed at our office, typically under IV sedation for patient comfort. Our surgeon makes a small incision in the gum tissue to uncover the impacted canine tooth. Any overlying bone is gently removed to fully expose the crown of the tooth.
An orthodontic bracket with a small gold chain attached is bonded directly to the surface of the exposed tooth. In most cases, the gum tissue is then sutured back to its original position, leaving only the chain visible as it exits through a small opening in the gum.
Post-operative bleeding is minimal, and some swelling around the lip is normal. A soft, bland diet is recommended initially. Most patients resume normal activity quickly. A follow-up visit at our office is scheduled 7–10 days after surgery to evaluate healing and ensure proper oral hygiene.
Within 1–14 days of surgery, you return to your orthodontist. A rubber band is attached to the chain to apply a gentle, continuous eruptive force on the impacted tooth — beginning the process of guiding it into its correct position in the arch. This phase continues over several months under your orthodontist’s supervision.
Experienced surgical care — coordinated with your orthodontist
Common questions about impacted canines
The canine tooth plays a unique and critical role in your bite. It is the first tooth to make contact when your jaws close, guiding all the other teeth into proper alignment. Canines also have the longest roots of any tooth in the mouth, giving them exceptional stability and longevity. Losing a canine affects chewing efficiency, smile aesthetics, and long-term bite function in ways that are difficult to fully replace — which is why every effort is made to bring an impacted canine into position rather than extract it.
The American Association of Orthodontists recommends a panoramic X-ray and dental examination around age 7 for all children. This allows clinicians to count the developing permanent teeth and identify any potential eruption problems early — including impacted canines — when treatment is most effective. If your child is approaching the mid-teens and a canine has not appeared, contact your dentist or orthodontist promptly.
The procedure itself is performed under local anesthesia or IV sedation, so there is no pain during surgery. Post-operative discomfort is typically mild — most patients describe it as less uncomfortable than expected. Some swelling around the lip is common for a day or two. Our opioid-free pain management protocol keeps recovery comfortable without narcotics, and most patients return to normal activity quickly.
After the orthodontist activates the chain 1–14 days after surgery, the canine moves gradually over several months under continuous gentle tension. The total time from surgery to full eruption varies depending on how deeply impacted the tooth was and the patient’s age — younger patients typically move their teeth faster. Your orthodontist will monitor progress at regular appointments throughout this phase.
In rare cases — typically in older patients with severely impacted canines that have ankylosed (fused) to the bone — eruption may not be achievable. In those situations, extraction is considered, followed by a tooth replacement option such as a dental implant or bridge. Our surgeons evaluate each case individually and will discuss all options with you and your orthodontist before proceeding.
The surgical portion of treatment is often covered at least partially by dental insurance, and Medicaid is accepted at all three of our locations. Coverage for the orthodontic component depends on your orthodontic plan. Our team will review your benefits before the procedure and help you understand your options — contact us before your consultation.
Save the tooth — restore the smile.
Our oral surgeons in Irving, Mesquite, and Ennis work hand in hand with your orthodontist to bring impacted canines into their proper place. Contact DFWOMS today to learn more.