1. 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
2. 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
