4 types of teeth

While many of us may not put too much thought into our teeth every day, their importance and function in our daily lives cannot be underestimated. From chewing our food to helping us smile and speak, teeth perform such a vital role in the way we live. However, aside from those studying to become a dental assistant, there are probably few who really critically think about the different types of teeth and the role they play in our lives.

Rather than delve into the benefits of oral hygiene, today we wanted to take a closer look into the different types of teeth we have and their use. While different numbers abound, it’s generally accepted that we have three different types of teeth: Incisors, canines, and molars. Yet, many will happily distinguish between the three different types of molars, including premolars and third molars. That leaves us with five different types of teeth. Below, we explore each type of tooth and its function in the mouth.


Incisors are often the first adult teeth that grow in after our primary teeth, or baby teeth, and make up most of our smile. There are eight incisors in the mouth; four in the top-center of our mouth and four in the bottom-center. These teeth are characteristically thin, flat-bottom teeth that help us to make the initial bite on our food. We bite into food with our incisors, tugging and pulling into our mouths. Incisors have a narrow-edge, and are adapted for cutting. The incisors are situated between the cuspids, or canines, and are often referred to as anterior teeth or front teeth because of their prevalence in smiling and talking.

Cuspids / Canines

Cuspids, also known as canines, are the closest link between the human mouth and that of a carnivorous predator, like a tiger or wolf. However, canine teeth in humans are not to be confused with those in man’s best friend. Mirroring the pointed teeth we associate with predatory animals and vampires, these are sharp, pointed teeth on either side of our incisors that are used to do exactly what they look like they are meant to do–tear into food and rip it apart. These pointed teeth usually come in permanently around the ten year mark, with the bottom cuspids arriving just before the upper cuspids. One feature of cuspids and canine teeth is the fact that they are our longest teeth, with a pointed end, and surprisingly, only one implanted root. Canines rip food, but their position on either side of the mouth help guide the mouth and other teeth into the best biting position.


Molars are our main masticators–that is, molars are the teeth we most commonly associate with chewing. While many may only recognize three types of teeth rather than five, the discrepancy comes in distinguishing between different types of molars.

Molars are simply large teeth with a flatter surface that are used to chew food into small, easily consumable pieces. Let’s look at the different types of molars below.

Premolars / Bicuspids

Premolars, or first molars, are our first molar teeth that tend to come in around twelve or thirteen years of age. Premolars sit next to the cuspids in the mouth and are the foremost molars in the mouth.

Wisdom Teeth / Third Molars

Wisdom teeth, or third molars, are often referred to as third molars because they are the last teeth to come into the mouth. Many often get their wisdom teeth removed; these teeth sit so far back in the jaw that they can often cause issues if not removed.

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Information on Canine Teeth

Information on Molars

Information on Oral Health

Information on Incisors

Healthy teeth are vital to oral health and play a major role in our ability to eat and speak, as well as our aesthetic appearance. Dr. Shervin Louie, renowned Los Angeles dentist, believes that everyone should know and understand the four main types of teeth, including their functionality and how to take care of them. This knowledge is essential to every person who takes a keen interest in maintaining their oral health. So, let us look at the four types of main teeth and how important their functionality is to us.

Four Main Types Of Teeth

Humans have two sets of teeth from which we develop four different types of teeth throughout our life span. These two sets of teeth are:

  • Primary
  • Permanent

The primary teeth set contains the infant or baby teeth. These teeth do not change their form until we grow into our early teens. Starting from the early teens, the first of the permanent teeth starts to appear in our mouth. Once we start to develop permanent teeth, their four different types start to evolve as we age through life. “These four types of teeth are about to play a major role in your life,” states Dr. Shervin Louie, a dentist in Los Angeles. Let’s learn about them now.


Incisors are the pair of eight teeth directly situated in the front and center of our mouth. The format includes four on top and four on the bottom. These teeth are immensely important since we use them to take the first bite of food or anything that you break with them (latter is a dangerous activity though). These teeth come in the first 6-months and then develop in a lifelong formidable shape between the ages of 6 – 8 years. Regular brushing keeps these teeth healthier and strong as well as good calcium diet.


There are four canine teeth in our mouth and these are the sharpest of all. These teeth first appear between 11 and 20 months of age and take their lifelong formidable shape between 11 to 12 years. These teeth should stay in healthy form because they are used to tear and wear your food and plays an important part in a proper digestion process.

Like the Incisors, two are located above and two below. These teeth along with Incisors play a vital role in digestion and presentation in the form of our smile. So bad habits like smoking and chewing betel nuts severely damages them and you may end up going to a dentist in Los Angeles for a treatment. Therefore, brush daily, do flossing between the gaps of these teeth, and avoid bad habits to escape severe disease or damage.


Premolar teeth are situated at each side of your mouth in deep settings. These teeth are used for chewing and grinding food so that it becomes totally in a semi-liquid form helping food particles to gulp down the throat and digest smoothly. These teeth first premolar in the upper jaw appears at the age of 10 while the second in the bottom appears at 11.

Since these teeth are situated deep into the mouth and rarely gets exposure to the outside air, Dr. Shervin Louie, the renowned dentist in Los Angeles, recommends a thorough brushing and the use of mouth rinsing agents in order to protect them from bacterial attack. Also, these teeth have the most higher chances of developing plaque, tarter, and germs because of their remote location so the methods mentioned above will give them good protection.


The final type of our teeth are the molars, a formidable replacement of permanent premolar ones. In the premolar form, there were only two teeth above and two below. However, when molars appear at the age 11 – 13 years, they add two more teeth to their pair – four above and four below –.

These molars will remain in their current form your entire life, given that you keep a good care of your dental health. As described above, molars are more prone to germ attacks and other deficiencies because of their remote location in your mouth so follow the methods of cleaning described by Dr. Shervin Louie in the paragraph above for premolars.

So, these are the major four types of teeth humans grow throughout their lifespan and their precious functionality which gives them an edge in our bodily system. As a great tip, apart from the daily care, you take off your dental health at home, it is recommended that you should at least visit twice a dentist in the 6-months period for a thorough checkup of your oral health.

A dentist is the scientist of oral and dental health and with their unique and exceptional knowledge, they utilize different methods to assess the early signs of any troubles within. You can also visit Dr. Shervin Louie who is a well-known Larchmont dentist for a checkup in the friendly and relaxing environment of his practice.

Types of Teeth and Their Functions

Most of us probably don’t give too much thought as to the different types of teeth we have and what their functions are. If you take a look in the mirror at your teeth you will notice that our teeth are quite unique and come is many different shapes and sizes.

Along with our teeth playing an important role in speech, being indicators of our overall health, the primary function of our teeth is to break down food by cutting and crushing it into easy to swallow pieces which prepares the food for digestion.

Adults have an average of 32 permanent teeth and each tooth has its own function and is designed to do different things. The four different types of teeth in the mouth and their functions are:

The middlemost four teeth on the top and bottom in your mouth. The two in the middle are the central incisors, the two on either side are called lateral incisors. These teeth easily cut and shear food into small pieces and help move food inwards into your mouth and towards other teeth. These are the teeth that are typically used with the first bite when biting into foods such as apples, veggie sticks or sandwiches.

Are the sharpest of teeth and located next to the incisors at the corners of the mouth. Sometimes they are called fang or eye teeth because of their pointy shape and sharpness. There are four canines, two on the top and two on the bottom and their function is to tear and shred food apart. Canines have the longest root of all teeth and are often referred to as the cornerstone of the dental arch as they are the start of the curve that leads to the back teeth.

There are eight premolars in the mouth two on each side of the mouth that sit behind the canine tooth. Premolars have a couple of sharp points on them which is helpful for piercing food as well as a flat surface which grind food into small particles. Premolars look like a mix between a canine and molar.

Molars are the last teeth at the back of your mouth. They are the largest and flattest teeth with a total of up to twelve in the mouth. There are three molars on either side and top and bottom of our mouth. The last molar is a wisdom tooth, which often is extracted.

The purpose of molars are to chew and grind down food into smaller pieces. As you eat food, your tongue pushes it back into your mouth towards the molars so they can grind down the foods into small, easy to swallow pieces.

To view a chart of all the types of teeth and their names .

Aside from teeth playing a vital role for us to be able chew food, teeth are also an important part of our appearance and structure of the face and helps with our speech and the pronunciation of certain sounds and words.

You may notice that your lips and cheeks are supported directly on your teeth, without them or even with missing teeth facial muscles can sag creating a sunken in appearance. Without teeth, speaking can also be challenging as the tongue working with the teeth is used to created certain sounds and words.

The dentists at North Burnaby Dental Group encourage everyone to do their best maintaining a good oral hygiene routine along with regular dental check ups to keep teeth healthy and functioning at their best.

If you have questions about your teeth and your oral health please ask your dentist at North Burnaby Dental Group as they will be happy to answer them.

Image Copyright: letyg84 / 123RF Stock Photo

Child and Adult Dentition

The human dentition is composed of two sets of teeth – primary and permanent.

Teeth are organised into two opposing arches – maxillary (upper) and mandibular (lower). These can be divided down the midline (mid-sagittal plane) into left and right halves. Teeth are positioned in alveolar sockets, and connected to the bone by a suspensory periodontal ligament.

In this article, we shall look at the structure of teeth, identifying teeth, and primary vs permanent dentition.

Primary and Permanent Dentition

The primary dentition is composed of 20 teeth, with 10 in each arch. There are five teeth in each quadrant, composed of two incisors (central and lateral), a canine, and two molars. These teeth are referred to as letters A, B, C, D and E. The primary teeth begin to erupt at 6 months of age.

The permanent dentition is composed of 32 teeth with 16 in each arch. There are eight teeth in each quadrant, composed of two incisors (central and lateral), a canine, two premolars, and three molars. These teeth are referred to as numbers, 1 (central incisor) to 8 (3rd molar or ‘wisdom’ tooth).

The permanent teeth begin to erupt, and replace the primary teeth, at 6 years of age. The permanent teeth complete eruption by approximately age 13 years – with the exception of the 3rd molar ‘wisdom’ teeth, which usually erupt by the age of 21 years.

Adapted from work by OpenStax College , via Wikimedia Common

Fig 1 – Primary and permanent dentition. The eruption dates for each tooth are denoted in brackets.

Tooth Structure

A tooth can be divided into two main parts – the crown and the root. The part of a tooth which is visible in the mouth is referred to as the clinical crown, while the part which is not visible is, by definition, the clinical root.

Anatomically, the crown and root can be distinguished based on their structure and the type of hard tooth tissue covering the external surface. Generally, the anatomic crown is covered by enamel, whilst the anatomic root is covered by cementum:

  • Enamel is a robust, avascular hard tissue with a high mineral content. It is, in effect, designed to provide thermal insulation for a tooth, and to protect the internal vital tissues from destruction. Enamel is susceptible to dental caries, tooth wear and acid dissolution.
  • Cementum is a softer, more sensitive tissue. It becomes visible if a tooth is extruded from the alveolar socket during a traumatic dental injury, and when periodontal disease (disease of the tooth supporting tissues) causes root exposure; a person becomes “long in the tooth”.

A layer of dentine lies beneath the enamel and cementum, throughout the crown and root. Dentine is a vital, innervated tissue that accounts for the majority of the hard tooth structure. The part of the tooth where the dentine and enamel meet is called the dentineo-enamel junction (DEJ).

The boundary where the anatomic crown meets the anatomic root (where the enamel meets the cementum) is called the cemento-enamel junction (CEJ). The pulp cavity is the space within a tooth root that is filled with the vital dental pulp, a pink mass of innervated, vascular tissue.

The end of the root is called the apex. The apical foramen is the space at the apex through which blood vessels and nerves enter the dental pulp, and through which pulp infection may enter the alveolus and surrounding soft tissues.

Adapted from work by Time3000 and Ian Furst , via Wikimedia Commonss

Fig 2 – Tooth structure. The anatomic crown is covered by enamel, whilst the anatomic root is covered by cementum.

Identifying Teeth

There are four main types of teeth – incisors, canines, premolars and molars. The premolars are only present in the permanent dentition.

Note: There is an accepted order that is used when naming teeth: dentition, arch, quadrant, tooth type. E.g. permanent mandibular right lateral incisor.


There are 8 incisors in both the primary and permanent dentition; 4 maxillary and 4 mandibular. Central and lateral incisors have straight edges that are designed to incise in to food. They are located at the front of mouth with central incisors nearest the midline, and lateral incisors between the central incisors and the canines.

Incisor teeth, particularly in the maxilla, are at risk of damage during a traumatic dental injury, due to their relatively unprotected position, and their size and shape. Traumatic dental injuries are common in childhood (at least 1 in 10 children are affected). The consequences of traumatic dental injuries can be significant in terms of function, aesthetics, dental anxiety, and quality of life for affected children and their carers.

By Ανώνυμος Βικιπαιδιστής , via Wikimedia Commons

Fig 3 – Labial and lingual views of the maxillary central incisor.


There are 4 canines in both the primary and permanent dentition; 2 maxillary and 2 mandibular. They are located at corners of the mouth and have an incisal edge that has a sharp, triangular shaped projection. The function of the cusp is to pierce and hold food. They are sometimes referred to as cuspid teeth.

Canines have long stable roots that withstand greater forces than incisors. Teenagers who experience dental crowding (the total width of the teeth exceeds the available width of the arch for the teeth to erupt in to) may present with unerupted canines. These are frequently located radiographically in the palate, or high the buccal sulcus. Oral surgery may be required to aid the eruption of these teeth.


The permanent dentition has 8 premolars that generally have 2 cusps, but this is not always the case. They are sometimes referred to as bicuspid teeth.

They are located between the canines and the molars, and they share some of the characteristics of these teeth. There are no premolars in the primary dentition. Premolar teeth are frequently extracted by dentists to relieve dental crowding, particularly prior to orthodontic treatment.


There are 8 molars in the primary permanent dentition; 4 maxillary and 4 mandibular. There are 12 molars in the permanent dentition; 6 maxillary and 6 mandibular. The number of cusps varies between 3 and 5. They are located at the back of the mouth, and are designed to crush and chew food, prior to swallowing.

Molar teeth are particularly at risk of dental caries (decay) due to the presence of deep grooves that run across the occlusal (top) surface of the teeth, and due to the presence of a relatively wide point of contact between adjacent molars. These sites are more difficult to clean than the smooth walls of the labial (lip), buccal (cheek), lingual (tongue), and palatal (palate) surfaces of teeth.

By Ανώνυμος Βικιπαιδιστής , via Wikimedia Commons

Fig 4 – Labial and lingual views of the maxillary first molar.

Mouth and Teeth

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Why Are the Mouth and Teeth Important?

Every time we smile, frown, talk, or eat, we use our mouths and teeth. Our mouths and teeth let us make different facial expressions, form words, eat, drink, and begin the process of digestion.

The mouth is essential for speech. With the lips and tongue, teeth help form words by controlling airflow out of the mouth. The tongue strikes the teeth or the roof of the mouth as some sounds are made.

When we eat, our teeth tear, cut, and grind food in preparation for swallowing. The tongue helps push food to the teeth, and allows us to taste the food we eat.

What Do the Parts of the Mouth Do?

The mouth is lined with moist mucous (MYOO-kus) membranes. The membrane-covered roof of the mouth is called the palate (PAL-it):

  • The front part consists of a bony portion called the hard palate. The hard palate divides the mouth and the nasal cavity above.
  • The fleshy rear part is called the soft palate. The soft palate forms a curtain between the mouth and the throat, or pharynx, to the rear. When we swallow, the soft palate closes off the nasal passages from the throat to prevent food from entering the nose.
    The soft palate contains the uvula (YOO-vyoo-luh), the dangling flesh at the back of the mouth. The tonsils are on either side of the uvula and look like twin pillars holding up the opening to the throat, or pharynx (FAR-inks).

A bundle of muscles extends from the floor of the mouth to form the tongue. The top of the tongue is covered with tiny bumps called papillae (puh-PIL-ee). These contain tiny pores that are our taste buds. Four main kinds of taste buds are found on the tongue — they sense sweet, salty, sour, and bitter tastes.

During chewing, salivary glands in the walls and floor of the mouth secrete saliva (spit), which moistens the food and helps break it down even more. Saliva makes it easier to chew and swallow foods (especially dry foods), and contains enzymes that help begin the digestion of foods.

Once food is a soft, moist mass, it’s pushed to the back of the mouth and the throat to be swallowed.

How Do Teeth Do Their Job?

Each type of tooth plays a role in the chewing process:

  • Incisors are the squarish, sharp-edged teeth in the front of the mouth that cut foods when we bite into them. There are four on the bottom and four on the top.
  • On either side of the incisors are the sharp canines. The upper canines are sometimes called eyeteeth or cuspids.
  • Behind the canines are the premolars, or bicuspids, which grind and mash foods. There are two sets, or four premolars, in each jaw.
  • The molars, found behind the premolars, have points and grooves, and allow for vigorous chewing. There are 12 molars — three sets in each jaw called the first, second, and third molars. The third molars are the wisdom teeth. Because they can crowd out the other teeth or cause problems like pain or infection, a dentist might need to remove them.

Humans are diphyodont (dy-FY-uh-dant), meaning that they develop two sets of teeth. The first set are 20 deciduous (duh-SID-you-wus) teeth that are also called the milk, primary, temporary, or baby teeth. They begin to develop before birth and begin to fall out when a child is around 6 years old. They’re replaced by a set of 32 permanent teeth, which are also called secondary or adult teeth.

What Are the Parts of the Teeth?

Human teeth are made up of four different types of tissue: pulp, dentin, enamel, and cementum.

  • The pulp is the innermost portion of the tooth and consists of , nerves, and blood vessels, which nourish the tooth. The pulp has two parts — the pulp chamber, which lies in the crown, and the root canal, which is in the root of the tooth. Blood vessels and nerves enter the root through a small hole in its tip and extend through the canal into the pulp chamber.
  • Dentin surrounds the pulp. A hard yellow substance, it makes up most of the tooth and is as hard as bone. It’s the dentin that gives teeth their yellowish tint.
  • Enamel, the hardest tissue in the body, covers the dentin and forms the outermost layer of the crown. It lets teeth withstand the pressure of chewing and protects them from harmful and changes in temperature from hot and cold foods.
  • A layer of cementum covers the outside of the root, under the gum line, and holds the tooth in place within the jawbone. Cementum is also as hard as bone.

How Can I Help Keep My Child’s Mouth and Teeth Healthy?

To help keep your child’s mouth and teeth healthy:

  • Offer a nutritious diet. Limit juice, sugary snacks, and sticky foods like dried fruit.
  • Go for regular dental checkups.
  • Help younger kids brush their teeth twice a day for 2 minutes at a time. Help your child start to floss once a day when the teeth touch each other.
  • Have your child use a mouthguard during sports where there is a risk of mouth injury.
  • Teach your child to never walk or run with anything in the mouth, such as a toothbrush or pencil.
  • Make your home and car smoke-free. Children exposed to secondhand smoke are more likely to get cavities. If you or anyone in your household smokes, call 1-800-QUIT-NOW for tips and advice on quitting.
  • Talk to the doctor or dentist if your child is still using a pacifier or sucking the thumb by the age of 4 years. They can give you tips to help you break your child of the habit, and see if it’s affecting the way the teeth line up.

Reviewed by: Larissa Hirsch, MD Date reviewed: October 2018

Know Your Smile: Teeth and Their Function

everyone has four different types of teeth.
each tooth has a unique name and a different purpose.

let’s be honest. most of us take our teeth for granted … until something goes wrong. our teeth help us chew and digest food, they play an important role in speech, and they impact our overall health. by brushing up on your dental health knowledge, you’ll be taking a step toward giving your teeth the attention they deserve. how much do you know about your pearly whites?

the adult mouth contains 32 permanent teeth, consisting of the following teeth types:

  • 4 lateral incisors
  • 4 central incisors
  • 4 canines (also called cuspids or eye teeth)
  • 4 first premolars (also called first bicuspids
  • 4 second premolars (also called second bicuspids)
  • 4 first molars (also called 6-year molars)
  • 4 second molars (also called 12-year molars)
  • 4 third molars (also called wisdom teeth)

Cure Male Impotence – How to Cure Erectile Dysfunction

your teeth help you chew your food, making it easier to digest. each type of tooth has a slightly different shape and performs a different job.

incisors are the eight teeth in the front and center of your mouth. these are used to take bites of your food. they cut (or incise) food with their thin edges, and are usually the first to erupt.

canines are the next type of teeth to develop. they are your sharpest teeth and are used for holding, grasping, and tearing food apart. sometimes called cuspids or eye teeth, these are the cornerstone of the mouth.

premolars, or bicuspicds, are used for chewing and grinding food.

molars are used for grinding food. some people never develop third molars.

the design of your mouth and it’s teeth is ingenious. your mouth is important! so don’t take your oral health for granted. brush and floss your teeth regularly, eat a healthy diet, and see your dentist regularly for dental cleanings and checkups. a healthy mouth = a healthy body…and a nice smile.

visit our website to read future “know your smile” dental facts!

Teeth Treatments

  • Brushing teeth: Daily brushing of the teeth removes plaque and helps prevent cavities.
  • Flossing teeth: Using floss or an approved dental gum cleaner cleans teeth below the gum line, where brushing cannot reach.
  • Rinsing teeth: Rinsing daily with an antiseptic mouthwash kills bacteria that cause bad breath and gum disease.
  • Teeth cleaning: Professional teeth cleaning every six months may help prevent teeth and gum disease.
  • Tooth filling: Drilling out the diseased part of a tooth and packing the space with a mineral filling can prevent a cavity from destroying the tooth.
  • Root canal: The deep pulp of a tooth is drilled out, cleaned, and filled. A root canal is done when damage to the teeth has affected the deep pulp.
  • Tooth extraction: If a tooth is too damaged to repair with a filling or root canal, it may be removed. Wisdom teeth are often extracted to prevent displacement of the other teeth.
  • Braces: An artificial device or system that places teeth under tension for a long period of time. Eventually, braces can help crooked teeth become realigned.
  • Mouth guard: A plastic mouthpiece can provide protection from teeth grinding and injury during sports.
  • Dental sealants: A plastic sealant applied to the teeth can help block bacteria from hiding in crevices on teeth surfaces. Sealants can help prevent cavities.
  • Teeth whitening: Over-the-counter and professional chemical treatments can bleach teeth to a brighter white. Tooth sensitivity is the most common side effect.

Dental Health Foundation

Tooth types

There are four different tooth types in the mouth.

The incisors at the front of the mouth have a sharp biting surface and are used for cutting or shearing food into small chewable pieces. There are eight incisors in both primary and permanent dentitions.

The canines are situated at the ‘corners’ of the dental arches. They have a sharp, pointed biting surface. Their function is to grip and tear food. There are four canine teeth in both primary and permanent dentitions.

The premolars, unlike the incisors and canines, have a flat biting surface. Their function is to tear and crush food. They are unique to the permanent dentition which has eight premolars.

The molars are the largest of the teeth. They have a large flat biting surface. The function of the molars is to chew, crush and grind food. There are eight molars in the primary dentition and twelve in the permanent dentition.

Key Points

  • There are 20 primary teeth
  • Lower incisors are usually the first teeth to erupt at about 6 months. All 20 primary teeth are usually in the mouth by about 2 years
  • There are 32 permanent teeth including 4 wisdom teeth
  • The first permanent teeth to erupt (usually at about 6 years) are the 4 first permanent molars behind the last primary teeth. Incisors erupt between 7 and 8 years.

Canine tooth

Canine tooth, also called cuspid or eye tooth, in mammals, any of the single-cusped (pointed), usually single-rooted teeth adapted for tearing food, and occurring behind or beside the incisors (front teeth). Often the largest teeth in the mouth, the canines project beyond the level of the other teeth and may interlock when the mouth is closed, restricting the animal to an up-and-down chewing action. Among sheep, oxen, and deer, only the upper canines are large; the lower ones resemble incisors. Rodents lack canines. The tusks of wild boar, walrus, and the extinct sabre-toothed cat are enlarged canines. (The tusks of elephants are upper incisors, not canine teeth. Canine teeth are absent.) In some animals (e.g., pig, deer, baboon, gorilla), the male has much larger canines than does the female; these perform a threatening and protective function besides that of tearing.

A yawning African lion (Panthera leo) showing its long canine teeth.© Jay Bo/.com

Humans have small canines that project slightly beyond the level of the other teeth—thus, in humans alone among the primates, rotary chewing action is possible. In humans there are four canines, one in each half of each jaw. The human canine tooth has an oversized root, a remnant of the large canine of the nonhuman primates. This creates a bulge in the upper jaw that supports the corner of the lip.

Impacted teeth including surgery for canine teeth

What are impacted teeth?

When one or more teeth fails to grow in the correct position and is therefore held below the normal gum line, it is called an impaction. This can be complete, such as completely unerrupted (buried) third molars (wisdom teeth) or partial when just part of the tooth is visible in the mouth.

Why are impactions important?

For best function and appearance the teeth should grow in a healthy alignment. When one or more teeth is impacted, this can affect the function of that tooth but also the function and appearance of other teeth.

Whether all impactions should be treated is still controversial and your dentist and oral and maxillofacial team can explain the advantages and disadvantages or treatment for you, which is usually surgical.

If impacted teeth are not treated, some can lead to medium and long-term problems such as decay, infection, gum disease and dental cysts – but these can all be watched out for by dentists.

What are canine teeth?

Normally, every adult has two canine teeth in each upper and lower jaw. They are the ‘pointier’ eye teeth (‘fangs’ in animals) that are in line with the corner of your mouth.

Children also have the same number of canine teeth but these will normally be shed when the adult (permanent) teeth replace them.

Canine teeth are more important than some other teeth for the correct function of the teeth and also for appearance. This is why dentists and orthodontists like to correct their position if possible.

When do permanent canine teeth appear?

Normally, the adult/permanent canine teeth in the upper jaw (maxilla) appear in the mouth (erupt) between the ages of 11 and 13 years. Just before this time, they can usually be felt as bumps on the gum.

What can go wrong with canine teeth?

Sometimes, because of the way teeth grow in the jaws and gums, one or both canine teeth develop in the wrong position for normal appearance or function. For example, they might erupt in the wrong position or not at all.

Dentists and orthodontists usually detect a problem with the canine teeth in children around the ages of 10-14 years, which is a time when they will recommend treatment.

Why can canine teeth grow incorrectly?

Canines are just one type of tooth. Some people never grow some teeth, which can be an inherited condition. Others have problems with the size, number or alignment of some or all of their teeth. The reasons for this can result from a mismatch in the size and shape of teeth, the soft tissues and underlying jaws – or it might be the result of early loss (or removal) of ‘baby’ (deciduous) teeth. Sometime people are just unlucky.

What can a misplaced canine look like?

Canines can fail to grow completely on one or both sides; this can either leave a gap between the incisors and premolars or the deciduous canine tooth will be retained, which in time might look too narrow or short.

Misplaced canines can also grow in the wrong place. They can erupt at the wrong angle or even behind the teeth in the palate.

What will happen if I have a misplaced canine?

The treatment options for impacted or misplaced canines will depend on the type and severity and the alignment of other teeth. Your dentist, orthodontist and/or oral and maxillofacial surgeon will explain the options to you, which can include surgery.

What might happen if I decide not to have treatment for my impacted canine tooth?

If an impacted canine is not treated, it can just remain buried and give you no more problems. Alternatively, it can lead to the following, which might or might not give you problems in the medium-long-term:

  • The tooth can continue to grow behind the other teeth in the roof of the mouth. In an effort to find a path into the mouth, some impacted canines might damage adjacent teeth by eating away or resorbing part of their roots, which might or might not give you problems.

  • If the deciduous canine has been lost and the permanent canine remains impacted, you might have a gap, which you might want to close up or replace with a false tooth of some kind (denture or ‘bridge’).

  • Sometimes a cyst can form around the crown of the buried tooth and this can push other teeth out of position.

If you have an impacted canine, you do not have to have surgery – this will be explained by your dentist or orthodontist. For example, if the buried tooth has not damaged the adjacent teeth, is not causing symptoms and the dental appearance is good then no treatment might be necessary.

Your dentist will probably want to keep an eye on the tooth though by taking regular X-rays.

Who will carry out the surgery for impacted canine teeth?

Who carries out surgery on canine teeth depends on the expertise of your own dentist or orthodontist and the nature and extent of the surgery required. Your dentist will explain this to you.

If you are referred to an Oral and Maxillofacial Department in a hospital such as Addenbrooke’s, they will work closely with your own dentist and/or orthodontist. Your treatment will be carried out at Addenbrooke’s and the options will be explained to you (you might have surgery under local or general anaesthetic)

What happens if I have an impacted canine?

Usually your dentist or orthodontist will diagnose the problem. They will notice that the tooth is not growing normally, will feel for the bump of the tooth in your palate or gum below your nose and will take some X-rays to check its existence and position.

Often the dentist will refer you to an orthodontist and/or an oral and maxillofacial surgeon for an opinion on the best ways of handling the problem.

What can be done surgically for impacted canine teeth?

There are several options for the surgical treatment of impacted canines. Your dentist will explain the options for you which might include:

  • Removed and discarded – This can be the treatment of choice if the buried tooth is in a poor position for orthodontic re-alignment, or shows signs of causing problems to adjacent teeth.

    Removal of the tooth involves a minor operation, which can be done under local or mostly under general anaesthetic.

    If there is a gap to fill where the canine tooth should be, it might be necessary to use a false tooth of some kind (denture or ‘bridge’)

  • Exposed before orthodontic treatment – If part of the tooth is exposed to the mouth it can allow an orthodontist to move it into correct alignment. This can be an option only if the buried tooth is in a reasonable alignment and the patient is prepared to wear an orthodontic fixed appliance for at least two years.

    The exposure of the tooth involves a small operation in the palate of the mouth, which is often performed under general anaesthesia. During this operation, some gum and bone overlying the tooth is removed so that the crown of the tooth is exposed.

    Sometimes, other teeth will need to be extracted to make space for the canine – your orthodontist will explain this to you.

    The oral and maxillofacial surgeon might place a dressing over the tooth, which is held with stitches that are removed after two to three weeks. An orthodontist then starts treatment to align the tooth.

  • Transplantation – Your oral and maxillofacial surgeon might suggest transplantation of the buried tooth if it is in a position where exposure followed by orthodontic treatment is not possible but there is adequate space between the other teeth. This entails an operation to remove the deciduous tooth if it is present, to remove the canine and replace it as carefully as possible in the correct position. The replaced tooth will need to be splinted for two to three weeks.

    The success rate of this procedure remains variable. If it is unsuccessful, the transplanted tooth does not function like a normal tooth and might have to be removed later on.

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