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Impacted cuspids

Cuspids, or canines, play an important functional role in our mouths. They guide the jaw as it moves, preventing other teeth from coming in contact with each other and protecting them from premature wear. Because cuspids are more solid than other teeth, they absorb more pressure and can withstand greater impacts.

Located in the corners of your smile, cuspids also play an important esthetic role by ensuring a transition between the narrow incisors and square molars.

What is an impacted cuspid?

Sometimes, permanent canine teeth don’t come in properly. When they grow in the wrong place or at an awkward angle, this is called “ectopic eruption.” If this happens, the tooth may come in on the outskirts of the dental arch or inside it, near the palate.

Cuspids may not come in at all or may get stuck in the jawbone—they then are known as “impacted cuspids.” After wisdom teeth, upper maxillary canines are most susceptible to becoming impacted. Most times, only one tooth is problematic, but in 10% of cases, both sides are affected. This condition is hereditary, affecting 1% to 2% of the population, and mostly women.

What causes this?

Permanent cuspids are large teeth with very long roots and a lengthy development period. Because they are the last front teeth to erupt, they have to make their way in between existing teeth and occupy the remaining space.

This space may sometimes be too narrow. Because adjoining teeth are already solidly in place, the canines may not be able to come in properly. In these cases, they may become impacted in the gums or erupt in another location.

Possible complications

  • Sometimes, a primary cuspid doesn’t fall out until much later
  • Lack of canine teeth affects your mouth’s function. Because they aren’t there to guide the jaw, other teeth come in contact with each other and get worn out prematurely
  • This situation can lead to the displacement or overlapping of teeth on the dental arch
  • An impacted tooth can cause unseen problems inside the gums
  • The roots of adjoining teeth can begin to resorb, which could lead to tooth loss
  • A cyst or a tumor could form


  • Extracting primary canines provides room for the permanent ones
  • Surgery and orthodontic treatments can help impacted teeth breakthrough:
    • An orthodontic bracket helps lower the tooth into position on the dental arch
    • In minor cases, this can be done by an orthodontist. For more severe cases (cuspids impacted on the side of palate or horizontally-positioned), the periodontist performs this procedure
    • This is a complex procedure and results are not guaranteed. Factors such as the severity of the case, the patient’s age, and his or her cooperation throughout the treatment can affect the outcome

Early detection and prevention

As with other dental problems, early detection is best. This way, corrective actions can be taken quickly for better results. To detect a problem early:

  • See your dentist regularly
  • Pay special attention to the development of your children’s permanent teeth
  • When your children reach the ages of 8 or 9, have panoramic x-rays taken for a precise diagnosis and, if needed, take preventive action

Keep in mind that the longer you wait to treat a dental problem, the harder it will be to resolve it. Orthodontics have certain limits: a cuspid that has been impacted for too long can become fused to the bone (ankylosis), making it impossible to remove and causing permanent damage to adjoining teeth.

Because canine teeth play such an important role on an esthetic and functional level, the dentist will do everything possible to ensure they come in—and stay in—properly.

If some of your relatives have had impacted cuspids, or if your child’s primary cuspids are taking a long time to fall out, schedule an evaluation with your dentist.