CLINICAL PROBLEM:

IMPACTED MAXILLARY CANINE TEETH

SPECIALTY: ORTHODONTICS

Patients should be examined from the age of 9 by their General Dental Practitioners to determine whether the canine is displaced from its normal position. The patient can be examined using 3 simple methods; visual

inspection, palpation and radiography. The ideal age of referral for patients with impacted canine teeth is 10-12 years. Initial referral from the General Dental Practitioner in cases with impacted canine teeth should be made to the Orthodontic Consultants for diagnosis and treatment planning.

Are both upper deciduous canines present?

Has one of the upper permanent canine teeth

already erupted?

Can the upper permanent canine bulges be palpated in the upper labial sulcus?

Yes

No

Patients in whom it is suspected that there are impacted canine teeth should be referred to the

Orthodontic Consultants, Miss J Clark or Mr A Pringle, MFU, St Richard’s Hospital, Chichester or

Worthing Hospital, Worthing.

Yes

Continue to monitor patient to ensure

normal eruption of the upper permanent

canines

Continue to monitor eruption of the

contralateral upper permanent canine.

Refer, if canine is still unerupted in 6 months

Is there excessive mobility of any of

the upper incisors?

No Yes

Can the contralateral upper permanent canine bulge be

palpated in the upper labial sulcus?

No

No

Yes

No

Yes

AUTHOR: Miss J Clark Consultant Orthodontist, Western Sussex Hospitals NHS Trust

OTHERS INVOLVED: Mr A Pringle , Consultant Orthodontist, Western Sussex Hospital NHS Trust.

REFERENCES:

BOS 2008 – Guidelines for Referrals for Orthodontic Treatment Ericson and Kurol:1998 European Journal of Orthodontics. RCSEng 2010 – Management of Palatally Ectopic Maxillary Canines.

PUBLISHED: 09/04 REVIEW: 01/07 & 05/09 REVIEW DUE: 10/13