Why does only the canine end up crooked?
The canines come in later than the front teeth and premolars, usually around age 11 to 13, so when there isn't enough room, they are the first to be pushed out. Because they come in after the other teeth have already taken their places, they emerge off to the lip side or high up on the gum. That is why I often hear in the clinic, “Only one canine sticks out. Do I really need full orthodontics?”
If the teeth are wide compared to the size of the jaw, or a baby tooth was lost early and the neighboring tooth tilted into that space, the room for the canine shrinks even more. Even if only one tooth seems to stick out, in reality the whole row of teeth is often short of space. So it is not a treatment that ends by simply pressing the canine inward.
When is partial orthodontics for a canine possible?
If the amount of movement is small, the front teeth are stably aligned, and there is no major problem with the back-teeth bite, I narrow the scope to partial orthodontics. I consider it if there is a small space beside the tooth, or if space can be opened with interproximal reduction, which very thinly reshapes the enamel where teeth touch. I also check whether the lips have to strain to close and whether the canine hits first when chewing sideways.
| Check | When we consider partial orthodontics | When we consider full orthodontics |
|---|---|---|
| Amount of movement | Small | Large, or several teeth overlap |
| Space | Room left beside it, or opened by interproximal reduction | The whole row is short of space |
| Bite | Back teeth are stable | Deep bite, or teeth don't meet well |
| Mouth shape | No need to push teeth further forward | Already protruding, so teeth can't be pushed further |
The overlap you see and the actual shortage of space often don't match. So I don't decide based only on how it looks in the mirror; I decide after checking the root positions, the spaces in the row of teeth, and the gums and alveolar bone (the bone that supports the teeth) on X-rays.
When shouldn't a canine be treated with partial orthodontics?
If the teeth overlap a lot or the canine is far out of line, it can't be brought in by moving only a few teeth. If the front teeth also stick out and they are pushed further to make room, the mouth looks even more protruding. If the upper and lower teeth bite too deeply or, conversely, don't meet well, pulling on just one side throws the bite off.
If there is no room and only the canine is pressed inward, it hits the roots of the neighboring teeth, and a tooth pushed outside the jawbone has its gums recede. Receded gums do not grow back. If there is no room, I don't just push the canine in. If extraction is needed, the scope is widened regardless of the name “partial,” but extraction is not the default.
How long does partial orthodontics for a canine take?
If the scope is narrow and the amount of movement is small, it usually takes around 6 months to 1 year, and full orthodontics that moves the whole row of teeth usually takes 1.5 to 2.5 years. It depends on where the space is opened and how much the root needs to be uprighted. Either way, a retainer must be worn afterward so the canine doesn't move back.
How we do it at Wonjin Dental
At the consultation, I look at the opposing teeth and the remaining space before the photo of the canine. If it is partial orthodontics, I explain why the whole row doesn't need to move; if full orthodontics is needed, I explain why the front teeth alone aren't enough. Wonjin Dental's fees for partial orthodontics (MTA) and full orthodontics (Clippy C self-ligating brackets) are published in All fees. Even if you want to finish quickly, the bite comes first.
Frequently asked questions
Can't a crooked canine just be covered with a porcelain veneer?
Placing a veneer on a canine that sticks out makes it look even more protruding, and making it look straight requires a lot of shaving. For a tooth whose problem is position, I look at moving it first. A detailed comparison is in Crooked teeth — cover them or move them?
Can partial orthodontics for a canine be done with clear aligners?
If the movement is small and the root doesn't need to be uprighted much, clear aligners sometimes work. The canine has a long root, so if its angle needs to change a lot, braces often have the advantage. The appliance is chosen after the movement plan is set.
Does the canine hurt during orthodontics?
For 2 to 3 days after the appliance is attached or adjusted, it often feels achy, and this usually lessens as you get used to it. If only the canine keeps hurting when chewing or it becomes very loose, I look at the bite again.
Can adults get partial orthodontics for a canine?
If the gums and alveolar bone are healthy, age alone doesn't rule it out. For adults, I check the gums first, and if there is inflammation, it is treated before starting.
