High Canines Treatment UK

Why do canines erupt in a high position?

Canines are the last of the front teeth to erupt, usually between the ages of eleven and thirteen. Because they are late arrivals, they are particularly vulnerable to being displaced if there is insufficient space in the arch. If the dental arch is crowded, the canine — finding its intended position already occupied or lacking room — may erupt higher in the arch, towards the lip or even towards the palate on the inside. In some cases the cause is a retained baby canine that has not been lost at the appropriate time, blocking the permanent canine's path. In other cases the lateral incisor next to the canine is missing or peg-shaped, meaning the space guidance it normally provides is absent. Genetics plays a role, particularly for palatal (inside-erupting) canines, which show a familial clustering.

Erupted high canines vs impacted canines — a critical distinction

Not all high canines are the same, and treatment differs significantly depending on whether the tooth has erupted through the gum or remains impacted within the bone. An erupted high canine has broken through the gum surface and is visible in the mouth, even if it sits well above the gum line or is rotated — this type can be treated with fixed braces alone in most cases. An impacted canine remains fully or partially within the bone and has not erupted, or has only partially erupted. Impacted canines require a surgical procedure — a minor operation under local anaesthetic, sometimes with sedation — to expose the tooth and bond a small gold chain or bracket to its surface so that the orthodontist can then apply gentle traction to guide the tooth down into the arch. This is a well-established and highly effective procedure, but it adds time and a surgical element to treatment.

Treatment for erupted high canines

When the canine has erupted but is positioned too high, the treatment approach is to create sufficient space in the arch for the canine to be moved downwards into its correct position. Space is created either by aligning and expanding the existing arch or, where crowding is significant, by extracting teeth — typically the first premolars. Fixed metal or ceramic braces are then used to apply forces that progressively move the canine down into the arch, rotate it if necessary, and align it with the adjacent teeth. The canine must be brought down to the correct height relative to the other front teeth and the gum level tidied up once tooth position is correct — a minor gum procedure is occasionally needed if the gum has not followed the tooth down naturally.

Treatment for impacted canines

Impacted canines require a two-stage process. First, fixed braces are placed on the other teeth to create and hold space for the canine. Once sufficient space exists, an oral surgeon or specialist periodontist performs a surgical exposure under local anaesthetic, uncovering the crown of the impacted tooth and bonding a gold chain or bracket directly to it. The wound is then sutured, and the chain is attached to the orthodontic archwire, applying a gentle, continuous pulling force to guide the tooth towards the arch. Over the following months — usually six to eighteen months depending on how deep the tooth is — the canine travels through the bone and gum into its correct position. The process requires patience but the outcomes are excellent in the vast majority of cases. The tooth, once fully in position, functions and looks like any other canine.

How long does treatment for high canines take?

Treatment duration depends heavily on whether the canine is erupted or impacted and on how much overall orthodontic correction is needed. For erupted high canines, total treatment is typically eighteen to twenty-four months with fixed braces. For impacted canines, the surgical and traction phase adds additional time, and overall treatment is commonly twenty-four to thirty months. Where skeletal problems exist alongside the displaced canine, treatment may be longer. Age matters too — younger patients in their early to mid-teens respond more quickly because the bone is less dense and tooth movement is faster. Adults can absolutely be treated successfully, but movement tends to be slower and treatment may take a little longer.

NHS eligibility and what happens if high canines are left untreated

High canines generally score well on the IOTN (Index of Orthodontic Treatment Need) dental health component, particularly when associated with crowding, and many patients qualify for NHS orthodontic treatment in the under-18 age group. Impacted canines in particular are routinely managed on the NHS. Adults do not qualify for NHS orthodontic treatment through the routine pathway and will require private treatment. Leaving a high canine untreated carries real risks. An impacted canine sitting adjacent to the roots of the lateral incisor or central incisor can cause root resorption — gradual destruction of the roots of those adjacent teeth — sometimes silently and without symptoms. This is one reason why impacted canines are taken seriously and treated proactively. Erupted high canines, while less urgent, can affect bite function, cause wear on opposing teeth, and represent a significant cosmetic concern for many patients.

Useful related pages

This guide is for general information only. It is not a diagnosis, treatment plan, or substitute for advice from a registered dentist or orthodontist.