Impacted canine tooth. Do I need to get braces or remove the tooth?

Question

Doctor, i am 20 years old. I had impacted tooth canine. The doctor said i was already 20 years, it may be a bit difficult, i need to take more time to get my tooth at the right position and she also not sure my tooth can be at the right posotion or not. Then, my teeth was okay and i do not have any bite problems. She suggest for me to remove that impacted teeth. Actually, I want to wear braces because I really do not want to remove my tooth. For your opinion, i need to get braces or remove the tooth?

Mary Jane (MJ) Rowland-Warmann, BDS, MSc · Answer

Hi there,
You essentially have three options here:
1. Leave the canines where they are and accept that they are in your head somewhere.  This may be ok for a while, but the risk is that they may turn into cysts over time and they should be regularly checked with X-rays in order to check for cystic change.  If they become cystic they may need to be removed.  Also, if they are pressing on another tooth or close to another tooth root, the impacted canine can resorb (dissolve) that tooth, causing damage to another healthy tooth.
2. Remove the impacted canines.  This involves surgery to remove them.  Surgery can involve pain, bad healing, scarring and other risks.  It can also damage the roots of teeth that are close to the canines, resulting in damage or loss to the existing teeth.  Removing the canines also means that you will either need replacements for them if you have spaces in the mouth, or that one of your other teeth is taking on the function of your canine.  Canines are very long, and cope with a lot of force in the mouth whilst chewing.  It is not always ideal for other teeth, such as premolars, to complete this job as they are a different shape and have different characteristics of the roots.
3. Orthodontically pull the canines into position.  This is possible, but depends on a fair few factors.  Firstly, it depends where they are in the head, and whether it is feasible to get a bracket onto the tooth and pull them into position.  If they are too far out of the way, or unfavourably placed, then it may not be possible to pull them into position.  The risk of pulling them into position alongside another tooth also can increase the risk of resorption (dissolving the root of the other tooth) along the way, so it must be done very very carefully.  Secondly, it depends on whether they will move.  Very occasionally, ectopic teeth (impacted teeth out of position) can be fused to the bone, meaning that even with orthodontic traction they will not move.  A further issue to consider is whether you have existing space in the mouth.  If you do, then getting the canines from wherever they are hanging out might be a good idea, but if there is no space then most orthodontists would tell you not to sacrifice a perfectly good tooth that is already in the mouth for an impacted canine which may or may not play ball and move into the space.  Other things to consider are whether the gum margins will look acceptable at treatment and other risks for treatment.  Getting the canines into position may take some years, but on the flip side there is no better replacement for your tooth than your real tooth.  
It is worth investigating your options with a competent and very experienced Orthodontic specialist.  Impacted canine retrieval is not a job for a general dentist, and you should choose a specialist with an appropriate level of experience.  This may need to be performed at a dental hospital to give you the best possible care as it is not easy, or straightforward.
Hope this helps!
Best,
MJ x

Tarsys Loayza, DDS, MSc · Answer

Good Afternoon!!!
I suggest you have to look for other opinion .but if you doctor give you a  diagnosis you have to recieve the solution.

Curtis B. Bedont, DMD · Answer

Impacted teeth can be very difficult to bring in and occasionally are in a position that if attempted to be brought in might compromise other teeth, so in this case it is best to remove the impacted tooth.  Other impacted teeth are relatively easy to be brought in.  
This forum is probably not the best place to try and answer your specific question about whether or not your tooth should be brought in or extracted, since we don't have all the information needed to answer your question.  If you are uncomfortable with your orthodontist's opinion, I recommend getting a second opinion from another orthodontist in your area.

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