Hi Dr. Hall,
I hope this finds you well. I’m 16 years old and still have one of my baby canine teeth. When I was 14, I lost one of my canines and the adult tooth grew back although it took quite a long time to erupt- maybe around 6 months. About a year ago I went to the dentist, he took an x ray and told me I had all my adult teeth but that I had a small mouth so it takes long for some of my teeth to erupt. He said that I would lose my other canine soon. Since then, nothing has changed as in my canine is not wobbly at all and I’m getting concerned that I’ll end up with a missing tooth at 17. I’m wondering if this is something I should be concerned about because my dentist acted like it was normal but I can’t find anything on the internet about it and I’m getting concerned. Also would there be a solution to covering my missing tooth while It grows back when or if I lose it. Thank you
– Missy
(See Dr. Hall’s answer below.)
We thank our advertisers who help fund this site.
Dear Missy,
The permanent canine teeth normally erupt around age 10-12. If they haven’t erupted by the age of 14, there is cause for concern. Occasionally, the canine teeth will be impacted, meaning that they won’t erupt by themselves, and they will need some help. The earlier that help is provided, the better the chance of getting the tooth into normal position. It is possible, after a number of years, for the canine to become fused to the bone, at which point it will be impossible to get it to move and it can only be extracted. So I disagree with your dentist about waiting until now—I think this should have been addressed a couple of years ago, not only for clinical reasons but for social reasons as well. It’s easier to address this at age 14 than at age 16 or 17.
A panoramic x-ray of your jaw should show if the root of the unerupted canine is fully formed. If it isn’t, it should have some erupting force that will help it to come in normally and it can be assisted by extracting the baby tooth, which will clear a path for it. That could have been done at age 14 if the permanent canine was close enough to the surface, but it can still be done now. If your baby canine is loose, the crown of the permanent tooth is probably right under the surface and hopefully will be able to come in on its own. If it’s not loose, the x-ray will show how close the permanent tooth is. Based on what you have told me about your dentist, I’m not confident that he’s going to give you an accurate picture, so I would consult with an orthodontist. The final forming of the root of the tooth gives it erupting force, so a judgment needs to be made about whether your permanent canine needs help coming in or not. I wouldn’t cover the space with a replacement tooth because that could interfere with the canine coming in.
If it does need help coming in, it isn’t that complicated a procedure. The crown of the canine needs to be fully exposed surgically. Then a bracket needs to be placed on it, as shown here:
(Image courtesy of Manhattan Oral Surgery & Implant Center)
You’ll see that there is a chain which is attached to a spring. As the canine comes in further, the chain is shortened, link by link, until it is fully erupted. It should take about a year to pull the canine into position.
If you have any further questions, feel free to ask. You can use the comment form below or use the “ask doctor” link that you used to send me the original question.
– Dr. Hall
Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.
About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
Thank you so much for the detailed explanation, Dr. Hall! It’s reassuring to hear that there are solutions if the tooth is impacted or hasn’t erupted yet.