Impacted canines
The upper canine (eye tooth) is the most commonly stuck tooth after wisdom teeth. Most are first noticed by the family dentist, and acting early gives the most options. These are the questions parents ask us most often.
Looking for an overview, fees and locations? See our Exposure of Impacted Teeth page.
About impacted canines
What is an impacted canine?
It is a canine that has not come through, or is not going to come through, on its own. About 1.5% of people have one, and most sit on the palate side (the roof of the mouth) rather than the cheek side.
What are the warning signs?
- The canine cannot be felt as a bump above the baby canine by about age 10–11
- One canine has come through or can be felt, and the other has not
- A baby canine still in place after about age 13
- A bulge on the roof of the mouth
- The front tooth beside it tilting or becoming loose
- Small or missing side incisors, which often go with canines on the palate side
Why does early action matter?
A canine that is out of position can damage the roots of the front teeth beside it. In one scanning study, almost half of children with an out-of-position canine had some root damage to the neighbouring teeth. This usually starts around age 11–12 and rarely starts after 14, so the window to prevent it is short.
Will my child need X-rays or a scan?
X-rays before age 10–11 add little. After that, your dentist usually takes two X-rays from slightly different angles to work out where the canine lies. A small 3D scan (CBCT) is only needed if the X-rays are not clear enough or damage to the front teeth is suspected.
Treatment options
Can taking out the baby canine help?
Sometimes. Removing the baby canine between about 10 and 13, when there is enough space in the arch, can encourage the adult canine to correct its path. Early studies reported improvement in 62–78% of cases, but the strongest recent review rated the evidence as weak. If this is tried, the canine should be checked again with an X-ray after 12 months. If it has not clearly improved, it is better to refer than to keep waiting. Both baby canines are often removed to keep the smile centred.
What does exposure surgery involve?
Exposure surgery uncovers the canine so it can come through or be guided into place by the orthodontist. We use three approaches, depending on how deep the tooth sits:
| Technique | What it involves | Best suited to |
|---|---|---|
| Laser exposure | The gum over the tooth is removed with a laser. Little bleeding, no dressing. The tooth comes through on its own or the orthodontist attaches a bracket. | Canines sitting just under the gum |
| Bonded open exposure | The tooth is uncovered and a small attachment is bonded to it at surgery, so the orthodontist can start moving it straight away. | Where the gum is likely to grow back over the tooth |
| Closed exposure | The gum is lifted, an attachment with a fine gold chain is bonded to the tooth, and the gum is closed. The orthodontist gently pulls on the chain. | Deeper or higher canines |
We do not use surgical packs (dressings). Research comparing open and closed approaches found similar success, gum health, appearance and comfort, so the choice depends on the tooth’s position and your orthodontist’s plan.
When does the orthodontist start moving the tooth?
Usually about 2 weeks after surgery. It works best if the braces are already on before the surgery, so there is no gap in which the gum can grow back or the attachment can come loose.
When is removing the canine the better option?
- When braces are not wanted or not suitable
- When the canine is lying flat, very high, or across the midline
- When the canine is fused to the bone, or moving it would worsen damage to the front teeth
- In older patients, as success with braces becomes less likely with age
Our results
How successful is the attachment?
From September 2022 to October 2026, Dr Jaunay performed 94 exposure procedures (123 teeth). In January 2025 we changed from button-style attachments to mesh-base attachments. Since the change, the share of patients whose attachments stayed bonded has risen from 86% to 96%. In the first 60 days after surgery, 4 of 28 patients with button attachments had an attachment come off, compared with none of 41 patients with mesh attachments.
Patients with mesh attachments have been followed for a shorter time, so we will report these figures again as follow-up grows. Across all patients, 92% of bonded attachments held. One canine did not come through after exposure and was removed.
Recovery
What should we expect after surgery?
| What you may notice | What we do |
|---|---|
| Discomfort and swelling for 2–3 days | Pain relief plan and a soft diet |
| Gum growing back over a laser-exposed tooth | A review at our rooms, and an attachment if the tooth stops coming through |
| The chain or attachment comes off | Call us straight away. Most happen in the first few weeks, and re-bonding is simpler before the gum heals over |
| The tooth moves slowly once the orthodontist starts | A joint review with your orthodontist, with a scan if needed |
There is no charge for aftercare, including reviews and re-bonding. See our post-operative instructions.
Fees
Will my child be awake or asleep?
A single canine sitting near the surface can often be exposed under local anaesthetic in our rooms for older children and teenagers. Deeper or two-sided canines, younger or anxious children, and cases where other teeth are removed at the same time usually suit a general anaesthetic in a private hospital.
How much does it cost?
| Fee | Typical amount |
|---|---|
| Exposure only (D381), per tooth | $515 |
| Exposure and bonding an attachment (D382), per tooth | $905 |
| Anaesthetist (general anaesthetic only) | $500–$900 |
| Hospital (general anaesthetic only) | $1,350–$2,650 |
Fees are before health fund rebates. Private hospital cover usually pays most of the hospital fee, less any excess. You will receive a written estimate with item numbers after your consultation.
- Zip Money: 6 months interest free on surgeon’s and anaesthetist’s fees where total estimated costs exceed $2,000 (Zip approval, fees and terms apply). See About our Fees (PDF) and Paying for your surgery with Zip Money (PDF).
- No charge for aftercare, including re-bonding reviews
Getting started
Do I need a referral?
Yes. Ask your dentist (or your GP) for a referral to Dr Tom Jaunay. If you already have a referral, call us and we will book you in.
What should I bring to my consultation?
- Your referral, and the X-rays or CBCT scan
- Which baby teeth have already been removed
- Your orthodontist’s name and plan, and whether braces are on
- Medical history and any medicines
How do I contact you?
Call 02 8513 9810 (8:30am to 4:30pm, Monday to Friday) or email reception@oromaxnsw.com.au. Sydney CBD Level 2, 225 Macquarie St · Hurstville Suite 9.06, Level 9, 288 Forest Rd · Miranda Suite 2, Level 5, 86 Kiora Rd. See our locations.
References
- Husain J, et al. Management of the palatally ectopic maxillary canine. Royal College of Surgeons of England. rcseng.ac.uk
- Ericson S, Kurol J. Resorption of incisors after ectopic eruption of maxillary canines: a CT study. Angle Orthod. 2000. PubMed
- Ericson S, Kurol J. Early treatment of palatally erupting maxillary canines by extraction of the primary canines. Eur J Orthod. 1988. doi:10.1093/ejo/10.1.283
- Benson PE, et al. Interventions for promoting the eruption of palatally displaced permanent canine teeth. Cochrane Database Syst Rev. 2021. doi:10.1002/14651858.CD012851.pub2
- Parkin N, et al. Open versus closed surgical exposure of canine teeth that are displaced in the roof of the mouth. Cochrane Database Syst Rev. 2017. doi:10.1002/14651858.CD006966.pub3
Our results come from an audit of all exposure surgery by Dr Jaunay at all Oromax sites, September 2022 to October 2026.
This page is general information to help you prepare for your consultation. It does not replace an assessment and advice about your own situation.