I’m 16 years old, and my upper and lower permanent canine teeth never came in. The baby teeth didn’t loosen or fall out, and the permanent ones never came in. Last December, my dentist removed the bottom teeth. The right permanent canine on the bottom was behind the primary tooth and grew almost in the right space. But the left permanent canine on the bottom is growing too close to the lateral incisor and leaving a space that looks like I have a missing tooth.

The issue with my canine teeth is leaving spaces between my teeth. I don’t want to remove the top canine teeth because I’m afraid that the permanent teeth will come up like the bottom ones and leave spaces. And then my other teeth will start moving, too. Are dental implants a solution for the spaces between my teeth? – Kerry

Kerry,

We are concerned about the situation you’ve described. If you have regular checkups, your dentist should address the problem. What you’re experiencing with your teeth is not uncommon, though. And dental schools train dentists on how to take good x-rays of your entire jaw to resolve the problem.

What Prevents Permanent Teeth from Erupting?

Often, permanent teeth don’t erupt because they are impacted. Some permanent teeth never form. Lateral incisors, lower premolars, and wisdom teeth most commonly don’t develop, but it’s rare for canine teeth not to develop. In the teenage years, when permanent canine teeth don’t erupt, it’s often because they are impacted.

If your dentist takes x-rays of your entire jaw, he’ll get answers to these questions:

• Where are the permanent teeth?
• Are they impacted?
• Are they in front of, or behind, other permanent teeth?

Orthodontic treatment will help the teeth erupt in the correct position. One treatment that allows an impacted a permanent tooth to erupt is for an orthodontist to make a surgical opening in the tissue to expose it. If necessary, the orthodontist might use braces and attach a bracket to the tooth to help it erupt in the correct position. An orthodontist will also determine if there is enough room for a tooth to erupt in the right place.

Canine teeth are anchor teeth and an essential part of your smile. It’s usually best to remove the first premolar to allow the canine to erupt. Afterward, braces can straighten the remaining teeth.

Will Dental Implants Work with Impacted Teeth?

Dental implants won’t work with impacted teeth because the teeth will block the implants. Implants require a clear path to fuse with your jawbone and remain stable. A dentist will only place implants if there are no teeth beneath them.

If your dentist can’t resolve the issue, we recommend that you get a second opinion or visit an orthodontist.

Michael Szarek, DMD, of Lowell, MA sponsors this post.