Retained teeth
Recently at work I have often been encountering a similar situation — patients, sometimes teenagers, sometimes adults, who are wondering about the look of their canines, come for consultation. We take a pantomographic x-ray (i.e. a review x-ray of all teeth) and it turns out that above the strangely small — but in fact milk canines — large, retained permanent canines are found…
A retained tooth is a tooth that has exceeded the time when it should appear in the mouth — by two years. The most common cases are those where third molars, i.e. “eights”, are retained — in these cases, patients usually learn about the retained teeth after a routine pantomographic examination. A retained canine is a bigger problem and generally the patients concerned seek help from the orthodontist themselves, quickly noticing the aesthetic disorders in their smiles. Retained canines are more common in women, and for our population as a whole this problem occurs only in about 2% of people. There may be several reasons for the canines to become retained — the genetic factor is often emphasized, as well as a disturbance in the development or shape of the lateral incisor root, as the canine grows along the root of the lateral incisor.
The position of the canines should be checked in the pantomographic x-ray at the age of 9, especially when the canines are still present in the mouth and do not move. In some cases, a rapid intervention — extraction of milk teeth — can prevent the canines from becoming retained.
How do we treat patients have retained teeth? In general, the treatment requires the application of permanent braces (i.e. orthodontic brackets) and restoration of the place for the retained tooth. The retained and displaced teeth often do not emerge themselves — an intervention of a dental surgeon is then necessary, in which case, under local anaesthesia, a surgeon exposes the retained tooth and then glues a bracket, with which we pull the tooth towards the braces.
In the pictures I attached you can see a retained canine, lying just behind the root of the lateral incisor.
The patient noticed only the abnormal position of the lateral incisor, which disturbed the aesthetics of the smile.