Impacted canine teeth: causes and treatment
An impacted canine is an eye tooth that is stuck in the gum or jawbone instead of coming in. Upper canines are the most common impacted tooth after wisdom teeth, affecting about 2% of people (Dental Press J Orthod review). Caught early, removing the baby canine is often enough for it to come in on its own; later, an oral surgeon exposes the tooth and an orthodontist gently pulls it into place with braces (Dental Press J Orthod review) (AAO). Here is how it's found, the treatment options, how long it takes and what to ask about cost.
Key points
- Impacted canines occur in roughly 1% to 4% of people; upper canine impaction is about twice as common in females (Dental Press J Orthod review)
- About two-thirds of impacted upper canines sit toward the palate, one-third toward the cheek (Dental Press J Orthod review)
- The main risk is damage to the roots of neighboring teeth (Dental Press J Orthod review)
- Pulling a canine into place takes about 12 months as a rule of thumb, often longer after puberty (Dental Press J Orthod review)
What an impacted canine is
An impacted tooth is one that doesn't erupt the way it should: it stays stuck in the gum tissue or jawbone, or only partly comes through (AAO). The AAO's glossary defines impaction as a tooth that doesn't erupt into the mouth or erupts only partially (AAO). Wisdom teeth are impacted most often (AAO); upper canines come second (Dental Press J Orthod review). Impacted canines are especially important in orthodontics because they help guide a healthy bite and shape the smile (AAO).
| Fact | Figure |
|---|---|
| Share of people with an impacted canine | About 1% to 4% |
| Upper canine impaction | About 2% of people; about twice as common in females |
| Upper vs lower jaw | About twice as common in the upper jaw |
| Both sides affected | About 8% of patients with an impacted upper canine |
| Position | About two-thirds palatal, one-third toward the cheek |
Figures as summarized in Dental Press J Orthod review, 2019 (a review in Dental Press Journal of Orthodontics).
Causes and signs
Common causes include a lack of space in the jaw, a tooth coming in at the wrong angle, crowding from neighboring teeth, something blocking the path, and family history (AAO). A baby tooth can also fuse to the bone and fail to fall out, blocking the adult tooth (AAO).
Many impacted teeth cause no obvious symptoms (AAO). Signs can include a gap where a tooth hasn't come in, gum swelling or sensitivity, and jaw pain (AAO). Call your dental provider promptly for swelling, worsening pain, drainage or fever (AAO).
How it's diagnosed
Because the tooth can sit under the gum, an exam alone can't show where it is: diagnosis takes dental imaging, usually X-rays and sometimes 3D imaging (AAO). Early diagnosis, while a child still has a mix of baby and adult teeth, can shorten treatment and make it simpler (Dental Press J Orthod review). That's one reason the AAO recommends a first orthodontic visit no later than age 7 (AAO).
Why it shouldn't be ignored
An impacted canine can damage the roots of the teeth next to it, especially the lateral incisors; CT studies cited in the review found incisor root resorption in 38% to 66.7% of cases (Dental Press J Orthod review). Other problems include cysts, gum infection, decay in hard-to-clean spots and shifting that affects the bite (AAO) (Dental Press J Orthod review). If the tooth isn't causing damage or symptoms, a provider may recommend monitoring with periodic exams and imaging (AAO).
Treatment options
| Option | When it's used |
|---|---|
| Remove the baby canine | Early, so the adult canine can come in on its own. The review reports about 91% spontaneous eruption when the canine's tip hasn't crossed the neighboring incisor, and about 64% when it has (Dental Press J Orthod review) |
| Create space | Appliances such as palate expanders make room for the tooth (AAO) |
| Expose and pull into place | Surgery uncovers the tooth and bonds an attachment, so the orthodontist can apply gentle traction over time (AAO); done with an oral surgeon and orthodontist working together (AAO) |
| Remove the canine | For a poor outlook; the space is then closed with braces or filled later with an implant (Dental Press J Orthod review) |
How long treatment takes
The review gives about 12 months as a rule of thumb for pulling a canine into place, usually longer after puberty because the bone is denser (Dental Press J Orthod review). That's on top of the rest of braces treatment, which for most people lasts 12 to 24 months (AAO). Impacted canines can complicate and lengthen orthodontic treatment (AAO), and space may need to be created before the tooth can be guided in (AAO). Common complications include bone loss, root resorption and gum recession (Dental Press J Orthod review). See how long braces take.
What treatment costs
We haven't found a reliable published price for canine exposure surgery. The total usually has two parts: the oral surgeon's fee for exposing the tooth, and the orthodontic fee for braces, which typically runs $3,000 to $7,000 for metal braces before insurance (CareCredit), at the higher end for a complex case (AAO). Ask:
- Is the exposure surgery billed by the surgeon separately, and is it covered by my dental or medical plan?
- Does the orthodontic fee include the extra months to pull the canine in?
- What happens to the fee if the tooth doesn't move and has to be removed?
The AAO's proposed criteria for medically necessary orthodontic care include impacted teeth that can't erupt but shouldn't be extracted, excluding wisdom teeth (AAO); payers aren't bound by them, so ask your plan. Insurance with orthodontic benefits pays up to a lifetime maximum; in OrthoFi data for 2021 the average benefit was $1,772 (Align Technology). More in braces cost with insurance and orthodontist vs dentist vs oral surgeon.
Questions people ask
What is an impacted canine?
A canine (eye tooth) that stays stuck in the gum or jawbone instead of coming in (AAO). Upper canines are the most commonly impacted teeth after wisdom teeth, affecting about 2% of people (Dental Press J Orthod review, 2019).
How is an impacted canine treated?
Early on, removing the baby canine often lets the adult tooth come in by itself. Otherwise an oral surgeon exposes the tooth and bonds an attachment, and the orthodontist pulls it into place with braces (AAO). Some canines with a poor outlook are removed.
How long does it take to bring down an impacted canine?
About 12 months of traction as a rule of thumb, usually longer after puberty, on top of the rest of braces treatment (Dental Press J Orthod review, 2019).
Is an impacted canine serious?
It can be. The main risk is damage to the roots of neighboring teeth, especially the lateral incisors; impacted teeth can also cause cysts and infection (review, 2019; AAO). Some are simply monitored with periodic X-rays.
At what age is an impacted canine found?
Often in childhood on X-rays. Early diagnosis while baby teeth remain can make treatment shorter and simpler, which is one reason the AAO recommends an orthodontic visit by age 7.
How much does impacted canine treatment cost?
We haven't found a reliable published price for exposure surgery. Expect a surgeon's fee plus the orthodontic fee, and ask whether each is covered by your dental or medical plan.
Sources
- What is an impacted tooth and how is it treated?. American Association of Orthodontists. February 13, 2026.
- Orthodontic traction of impacted canines: concepts and clinical application (Cruz RM, Dental Press J Orthod 24(1):74-87). Dental Press Journal of Orthodontics (peer-reviewed), via PubMed Central. January-February 2019.
- Medically necessary orthodontic care (definition and proposed auto-qualifiers). American Association of Orthodontists. Definition amended April 27, 2025.
- Glossary of orthodontic terms. American Association of Orthodontists. Accessed October 13, 2026.
- How do braces work?. American Association of Orthodontists. Accessed October 12, 2026.
- Average costs of orthodontics procedures by service (CareCredit data). Becker's Dental Review. October 21, 2022.
- How much do braces cost? Factors, insurance and savings. American Association of Orthodontists. Accessed October 12, 2026.
- Invisalign insurance and payment options (citing OrthoFi data for 2021). Align Technology, maker of Invisalign. Accessed October 12, 2026; OrthoFi data on file January 19, 2023.
Figures are national averages or ranges from these sources. Estimates from our calculator are a model, explained on how we get our numbers.