Impacted Canine Teeth in Children & Teens
Medically reviewed by Dr. Sergio Calleja, DDS, MPH — Board-Certified Oral & Maxillofacial Surgeon · Last reviewed 2026-07-11
Canines — the pointed "eye teeth" at the corners of the smile — are cornerstone teeth: they guide the bite as the jaw moves and anchor the shape of the smile. They are also, after wisdom teeth, the teeth most likely to get stuck on the way in. When a canine cannot erupt on its own, orthodontists call it impacted.
Here is the part every parent should know: timing is nearly everything. Caught between roughly ages 10 and 14, an impacted canine can usually be guided into its proper place and function for a lifetime. Discovered years later, options narrow. This page covers the warning signs, why early X-rays matter, and what treatment actually involves.
Why Canines Get Stuck
Upper canines are among the last front teeth to arrive — typically around ages 11 to 13 — and they travel the longest path through the jaw to get there. If the dental arch is crowded, if baby teeth exit off-schedule, or if the canine's path drifts (often toward the roof of the mouth), the tooth can wedge against neighboring roots or simply stall in the bone.
Most impacted canines cause no pain at all — which is exactly why they are missed. The tooth sits silently in the palate or gum while the smile above it looks unremarkable, apart from a stubborn baby tooth or a lingering gap.
Warning Signs for Parents
- A baby canine still firmly in place around age 13 or later — baby canines normally fall out around 10 to 12
- The adult canine has not appeared by about a year after its expected time, especially if the same tooth on the other side came in long ago
- A gap at the corner of the smile that is not closing
- A bulge you can see or feel in the gum or the roof of the mouth where the tooth is lodged
- Adjacent teeth tilting, shifting, or (on X-ray) showing root changes
- Marked asymmetry: one canine fully erupted, the other absent for a year or more
Why Ages 10–14 Are the Golden Window
A canine's root is still forming through the early teens, and while it is, the tooth retains its natural drive to erupt. Treatment in this window works with that drive: create space, expose the tooth, and guide it in — and the tooth cooperates.
This is why the American Association of Orthodontists recommends every child have an orthodontic evaluation by around age 7, and why panoramic X-rays in the pre-teen years matter: an impaction spotted at 10 can sometimes be prevented outright just by extracting the baby canine at the right moment and making room. The same impaction found at 25 may have lost its eruptive potential entirely — or fused to the bone — leaving extraction and an eventual implant as the honest recommendation.
How Treatment Works
For a canine that cannot make it on its own, the standard of care is a team approach called expose and bond, coordinated between the orthodontist and the oral surgeon:
- The orthodontist first creates space in the arch with braces, so the canine has somewhere to go
- In a short outpatient procedure, the surgeon uncovers the tooth and bonds a tiny bracket with a gold chain to it
- Over the following months, the orthodontist applies gentle, steady traction through the chain, walking the tooth into its proper place
- Once erupted, the canine is aligned like any other tooth — and a guided canine, with healthy root and gum, is a permanent tooth, not a compromise
What Happens If It's Left Alone
An impacted canine that is simply ignored can behave for years — or it can quietly cause trouble: pressure on the roots of neighboring incisors (which can shorten them), drifting of adjacent teeth into the gap, cyst formation around the buried tooth, or a retained baby canine that eventually gives out decades before an adult tooth would have.
That does not mean every impacted canine must be dragged into place — in some cases, monitoring or extraction is the reasonable plan. It means the decision should be made deliberately, with X-rays, at the age when all options are still on the table.
Seek Care Promptly If
- Pain, swelling, or infection around a baby tooth or an unerupted tooth
- A visibly growing bulge in the palate or gum
- Front teeth becoming loose or shifting in a pre-teen or teen — root pressure from a migrating canine should be ruled out promptly
Office: (301) 645-6911 (Waldorf) · (301) 863-8107 (California, MD). For emergencies, call 911.
The Treatment: Expose & Bond
Dr. Calleja performs the surgical side of canine guidance — exposing the impacted tooth and bonding the traction chain — in coordination with your child's orthodontist. Our complete guide covers the procedure, anesthesia options for children and teens, and the month-by-month journey to a finished smile.
Read the Impacted Canines Guide →Frequently Asked Questions
At what age should a canine tooth come in?
Upper adult canines typically erupt around ages 11 to 13, lowers slightly earlier. A baby canine still firmly in place at 13, or an adult canine absent a year after its opposite-side twin arrived, is a reason for a panoramic X-ray.
How do I know if my child's canine is impacted?
You often can't from looking — most impacted canines are painless and hidden. The clues are indirect: a retained baby canine, a gap that isn't closing, or a bulge in the palate. The definitive answer is a panoramic X-ray, which is exactly why orthodontic evaluations in the pre-teen years matter.
Can an impacted canine come in by itself?
Sometimes — if the obstacle is removed early enough. Extracting the baby canine and creating space around ages 10 to 12 gives a mildly off-course canine a real chance to self-correct. The more displaced the tooth and the older the patient, the less likely unaided eruption becomes.
Is the expose-and-bond surgery hard on a child?
It is a short outpatient procedure, typically done with IV sedation so your child sleeps through it, with a sore-gum recovery measured in days. The orthodontic guidance afterward is gradual and low-drama — most of the "treatment" is simply braces doing slow, gentle work.
What happens if an impacted canine is never treated?
Possible consequences include root damage to neighboring front teeth, drifting of adjacent teeth, cyst formation around the buried tooth, and a retained baby canine that fails years down the road. Some untreated canines cause no harm — but that is luck, not a plan. An informed decision at the right age beats discovering the problem at 30.
My orthodontist found an impacted canine in me as an adult — is guidance still possible?
Occasionally, but honestly less often. An adult canine may have lost its eruptive drive or fused to the bone (ankylosis), in which case traction cannot move it. Adults are evaluated case by case — and when guidance isn't realistic, extraction with an implant plan is a well-proven path.
Not Sure What You're Dealing With?
A consultation with imaging gives you a real answer — and a plan, even if the plan is simply to watch and wait.
Related Guides
This page is general patient education, not a diagnosis. Only an in-person examination can determine what is causing your symptoms and which treatment, if any, is right for you. For emergencies, call 911.