If your child's dentist or orthodontist has mentioned an "impacted canine" and referred them for exposure surgery, it's natural to have questions. This guide explains what impaction means in this context, why the procedure is needed, and what to expect for your child.
The upper canine teeth (the pointed teeth just behind the front incisors) are among the last teeth to come through, usually erupting between ages 11 and 13. Occasionally, a canine becomes impacted, meaning it's unable to erupt into its normal position, often because it's blocked by another tooth, growing at an unusual angle, or simply doesn't have enough space.
This is usually picked up either through a routine dental check, when a baby tooth doesn't fall out as expected, or via X-ray during orthodontic assessment.
Canines play an important role in a healthy, functional bite, and losing one from the dental arch isn't a small cosmetic issue. It can affect both function and long-term dental alignment. Left untreated, an impacted canine can also occasionally cause damage to the roots of neighbouring teeth. For these reasons, the aim is almost always to bring the tooth into its correct position, rather than remove it.
This is a two-part process, involving both a specialist oral surgeon and an orthodontist, usually planned together from the outset.
1. Surgical exposure
Under local anaesthetic (sedation is also available for anxious children or teenagers, or in some cases a referral for general anaesthetic may be appropriate), a small procedure is carried out to:
2. Orthodontic guidance
Once healed, the orthodontist attaches the chain to a brace, gradually and gently guiding the tooth down into its correct position over a period of months. This is a slow, carefully managed process, canines cannot be rushed into place without risking damage to the tooth or surrounding structures.
The procedure itself is carried out under anaesthetic, so your child won't feel it happening. Afterwards, similar to a surgical extraction, some mild swelling and discomfort is normal for a few days, generally well managed with age-appropriate pain relief. Most children and teenagers return to school within a day or two.
In a small number of cases, depending on the severity of impaction, the position of the tooth, or resorption (damage) affecting a neighbouring root, exposure and orthodontic guidance may not be advisable. Removal of the impacted tooth may be recommended instead, with the space managed orthodontically or restoratively. This decision is made collaboratively between the surgical and orthodontic team, with your involvement throughout.
Timing is planned jointly between the orthodontist and oral surgeon, based on your child's dental development, X-ray findings, and orthodontic treatment plan. Because early identification generally leads to better outcomes, cases picked up earlier in adolescence often have more favourable prognoses than those identified later.
It's natural for children and teenagers to feel some anxiety about a surgical procedure. We take time to explain things in an age-appropriate way, involve parents throughout, and offer sedation options where appropriate to help make the experience as comfortable as possible.
Been referred for canine exposure, or have questions about the process? Get in touch with our specialist team, we're happy to talk it through.
This article is written for general information and does not replace individual clinical advice. Please consult our specialist team or your own dentist about your specific circumstances.
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