My 13 year old daughter has been seeing an orthodontist for several years and has braces. The permanent canine tooth on top right has not come in and she is scheduled for oral surgery to remove this tooth. My question is could this tooth be placed in the correct spot in her mouth or will she have to have an implant? The orthodontist has really done a wonderful job with her teeth and we are pleased with the progress so far. I am also wondering why this occurred. She did have her jaw expanded on top and I am thinking this might have caused the tooth to be pushed further upwards. The X-rays showed the tooth coming in behind the molar. I only want the best for her and want her to have a beautiful smile. We have invested around $9000 so far. I also wonder if I should get a second opinion from another orthodontist. Thank you for your time, Leia Alexander
Leia - First of all, if you have any questions about the orthodontist, get a second opinion.
It is not totally unusual for canine teeth to develop in an altered position. Some of them are vertical and never erupt and a surgeon needs to expose it in the bone and apply a bracket to allow the orthodontist to pull the tooth down into position. If your daughter's tooth is not vertical or at an angle then pulling it into position can be very difficult and occasionally impossible. For a canine to be so far back at the molar location, it is wrong to try to bring it forward, since damage to adjoining teeth could occur.
Cosmetic and functional results are important. If the tooth cannot be pulled into normal position then the space may be held open for an implant or the space closed and the tooth recontoured and a crown placed. In this day an age an implant would be great, but it should not be placed until her puberty has ended and her bones have completely formed.
If you have additional question, feel free to contact me again.