--- title: "Impacted Canine Teeth: UK Treatment Guide" url: https://virtualconsultant.online/guides/impacted-canine-orthodontics-uk description: "An impacted canine needs surgical exposure and gold chain traction with braces to guide it into place. See CBCT assessment, timelines and NHS eligibility." updated: 2026-08-09T00:00:00Z publisher: Virtual Consultant Online --- Impacted Canine Oral Surgery Orthodontics # Impacted Canine Teeth: UK Treatment Guide An impacted upper canine is one of the most common and clinically significant orthodontic problems in young patients. When a canine fails to erupt naturally and becomes stuck in the palate or bone, a coordinated approach involving orthodontics and oral surgery is required to bring it into the correct position. [Start Photo Assessment](https://virtualconsultant.online/evaluations/quote) [Compare Costs](https://virtualconsultant.online/costs) ## What is an impacted canine? Upper canines are the pointed teeth sitting between the incisors and premolars. They have the longest roots of any tooth and are the last anterior teeth to erupt, typically between ages 11 and 13. Because they travel the furthest through bone before erupting, they are the most likely teeth (after wisdom teeth) to become impacted — meaning they fail to erupt into their correct position and remain buried in the bone or palate. Palatal impaction (the canine stuck in the roof of the mouth, behind the other teeth) accounts for approximately 85% of impacted upper canines. Buccal impaction (the canine stuck in the bone on the cheek side) accounts for the remaining 15%. Upper canine impaction affects approximately 2% of the UK population, making it a common reason for orthodontic referral. Impaction is slightly more common in females and often runs in families. ## How is an impacted canine detected? Impacted canines are most commonly detected at routine dental examinations or during orthodontic assessment, typically when a patient is aged 10 to 14. Signs that raise suspicion include the absence of the permanent canine in the dental arch after the expected eruption age, persistence of the baby canine well beyond its normal exfoliation time, and a palpable bulge on the palate. Radiographic confirmation is essential. An OPG (dental panoramic radiograph) gives an initial overview and confirms the impacted canine is present in the bone. To accurately determine the three-dimensional position of the canine — its exact location relative to adjacent roots, its angulation, and whether it is causing resorption of neighbouring teeth — CBCT (cone beam computed tomography) is now routinely used in the UK. CBCT provides a three-dimensional image with lower radiation dose than conventional CT and is considered the gold standard for planning impacted canine treatment. ## Surgical exposure — open versus closed technique Treatment of an impacted canine requires a surgical procedure to uncover it, followed by orthodontic traction to guide it into the arch. There are two main surgical approaches. The open technique involves removing the overlying tissue and bone to expose the crown of the canine, leaving the crown exposed to erupt spontaneously or to receive a bracket immediately. The surgical wound heals around the bracket. This technique is most suitable for buccally positioned canines and some palatal canines in younger patients where spontaneous eruption is expected. The closed technique (also called the tunnel or attachment-first technique) involves a surgeon lifting a flap of gum, bonding a small gold chain or bracket directly to the crown of the impacted canine, and then replacing the gum over the tooth. The chain exits through the gum and is attached to the orthodontic archwire to apply gentle traction. This is the most commonly used technique for palatally impacted canines in the UK. The choice between techniques depends on the canine's position, the patient's age, and the surgeon's and orthodontist's combined assessment. ## How does gold chain traction guide the canine into place? Once the surgical attachment is in place, the orthodontist applies gentle continuous force to guide the canine along a controlled path into its correct position. This traction phase is incorporated into fixed brace treatment. The orthodontic archwire typically needs to be in place before surgery — or is placed shortly after — to provide the anchor system for traction. Forces are usually light and continuous, using elastic chains or coil springs. The canine moves slowly through bone, which is normal and necessary. Space must be created in the arch to receive the canine before it arrives, and this space management is a key part of treatment planning. Regular review appointments allow the orthodontist to monitor progress and adjust the traction mechanics. ## Treatment duration, success rates, and what happens if untreated The traction phase for an impacted canine typically adds 12 to 18 months to overall treatment time, on top of the time required to finish aligning and detailing the rest of the dentition. Total treatment duration including the orthodontic finishing phase is commonly 2 to 3 years for complex cases. Success rates are high — published studies report successful eruption and positioning of the impacted canine in approximately 80 to 90% of cases. Factors affecting prognosis include the degree of canine angulation, proximity to adjacent roots, and whether any root resorption of neighbouring incisors is already present. If an impacted canine is left untreated, several problems can arise over time: resorption of the roots of adjacent incisors (particularly the upper lateral incisor), development of a dentigerous cyst around the unerupted crown, and permanent retention of the baby canine which will eventually be lost, leaving a gap. Early detection and treatment — ideally before age 14 — generally produces better outcomes. ## Is impacted canine treatment available on the NHS? Impacted canine treatment is almost always eligible for NHS treatment in patients under 18, as it is functionally necessary and typically achieves a high IOTN grade. NHS treatment is provided through an orthodontic specialist practice or hospital orthodontic department, often in conjunction with an oral and maxillofacial surgery (OMFS) department for the surgical component. NHS waiting times for treatment can be significant in some regions, but early referral from the GDP when the impaction is detected is the most effective way to minimise delay. Adult patients with impacted canines may still qualify for NHS treatment if the case is sufficiently complex or if they have been on a waiting list since childhood. Private treatment is available for patients seeking faster access or for adults who do not qualify for NHS provision. ## Useful related pages [CBCT vs OPG X-ray UK](https://virtualconsultant.online/guides/cbct-vs-opg-xray-uk) [Orthodontic X-ray Radiation UK](https://virtualconsultant.online/guides/orthodontic-xray-radiation-uk) [Orthognathic Surgery Timeline UK](https://virtualconsultant.online/guides/orthognathic-surgery-timeline-uk) [Malocclusion UK](https://virtualconsultant.online/guides/malocclusion-uk) [Orthodontic Guides](https://virtualconsultant.online/guides) This guide is for general information only. It is not a diagnosis, treatment plan, or substitute for advice from a registered dentist or orthodontist. ### Compare next steps [Orthodontist Near Me](https://virtualconsultant.online/locations/orthodontic-treatment-near-me) [Clear Aligners Near Me](https://virtualconsultant.online/treatments/clear-aligners-near-me) [Invisalign Near Me](https://virtualconsultant.online/locations/invisalign-provider-near-me) [Browse Locations](https://virtualconsultant.online/locations) ### Ready for a clearer starting point? Upload guided photos and receive an indication of likely treatment options and pricing before booking appointments. [Get an Online Quote](https://virtualconsultant.online/evaluations/quote) ### Frequently Asked Questions How common are impacted canines in the UK? Upper canine impaction affects approximately 2% of the UK population, making it the most common tooth impaction after wisdom teeth. Of those impacted canines, around 85% are palatal — stuck in the roof of the mouth behind the other teeth — and about 15% are buccal, held in the bone on the cheek side. Impaction is slightly more common in females and has a genetic component, so it often runs in families. Most cases are picked up between ages 10 and 14, at a routine dental or orthodontic examination. At what age should an impacted canine be treated? Treatment is most effective when started in the early to mid-teenage years, ideally before age 14 to 16 when the bone is less dense and the canine is more responsive to traction. That said, successful treatment is possible in adults — it simply tends to take longer and may carry a slightly higher risk of complications. Early detection at routine dental appointments is the most important factor. Will I need surgery? Yes. An impacted canine that has not erupted naturally requires a surgical procedure to expose the crown and attach a chain or bracket. This is usually performed under local anaesthetic as a day procedure, either at a specialist oral surgery practice or an NHS hospital OMFS department. General anaesthetic is available for patients with significant anxiety or special needs. Does gold chain traction hurt? Most patients adapt to the gold chain within a few days of surgery. The chain is thin and lies within or close to the gum. Some patients experience mild discomfort when traction is first applied and after adjustment appointments, similar to normal brace adjustment soreness. Significant ongoing pain is uncommon and should be reported. Will the treatment affect the teeth next to the impacted canine? The main risk to adjacent teeth is root resorption — where the root of the impacted canine presses against and erodes the roots of adjacent incisors, particularly the upper lateral incisor. CBCT assessment before treatment allows accurate evaluation of any existing resorption and guides the surgical and orthodontic approach to minimise further damage during traction. Your orthodontist will discuss this risk specifically during consent. Is impacted canine treatment available on the NHS? Yes. Treatment for impacted upper canines in patients under 18 is almost always NHS eligible because it is clinically necessary and typically achieves a high IOTN score. The orthodontic component and the surgical component are both provided on the NHS through the appropriate referral pathways. NHS waiting times vary by region. Adult patients should discuss eligibility with their orthodontist. What if the canine cannot be brought down successfully? In a small number of cases — where the canine is very severely angled, where significant root resorption of adjacent teeth has already occurred, or where traction has failed after a reasonable period — the impacted canine may need to be extracted and alternative treatment planned. Options include closing the space with other teeth, using a dental implant in the canine position once growth is complete, or accepting the retained baby canine for as long as it remains functional. Explore your options Quick links Not sure where to start? Use these quick links to explore orthodontic treatments, typical costs, and helpful guides that explain what different options involve. Whether you're researching braces or clear aligners, comparing pricing, or just getting a feel for what comes next, you can browse at your own pace and come back when you're ready to request a quote. 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Upload guided photos and get a tailored recommendation for your teeth and bite. [Start Photo Assessment](https://virtualconsultant.online/evaluations/quote) [Find an Orthodontist](https://virtualconsultant.online/locations) Citation details Title Impacted Canine Teeth: UK Treatment Guide Publisher Virtual Consultant Online Published 2024-06-01 Updated 2026-08-09 URL [https://staging.virtualconsultant.online/guides/impacted-canine-orthodontics-uk](https://staging.virtualconsultant.online/guides/impacted-canine-orthodontics-uk)