Can I live without canines?
Question from Yasmine, an internet user.
I’m 18 years old and I have impacted canines, but I do not want to undergo the surgery.
So, I need your advice.
Can I live without canines?
Good morning Yasmine,
I apologize for taking a few days to answer your question. You have an excellent question that is worth thinking about.
Can we live without canines?
The answer is yes, we can live without canines. Except that you are not asking the right question.
You mention having to undergo a surgery which would be done to expose and ligature the impacted canine for an orthodontic traction. Yet, you refuse the surgery. This means that your canine will stay impacted.
The right question
The right question to ask is:
What are the risks associated with keeping one or more impacted canines?
First, I will show you a few examples of occlusion without permanent canines. Then I will illustrate a few examples of damage that an impacted canine can cause.
Occlusion without canine(s)
Cases #1 and #2 each had their canine #13 impacted and ankylosed, that is fused to the bone. It was thus impossible to proceed with their orthodontic traction. The removal of the impacted tooth was necessary. The patients were told that the removal of 3 premolars (#24, #34 and #44 for case #1 and #24, #35 and #45 for case #2) would be necessary to obtain an ideal occlusion. The Xs represent the spot where the canines would be if they existed. The first premolars #14 and #24 are identified. The replacement of canines by first premolars allows the patient to obtain an acceptable esthetic and functional result.
The picture on the left represents the ankylosed canine of case #2. The tooth crown is delimited by the dotted line. No space was visible between the enamel and the bone, confirming the ankylosis (fusion to the bone) of the tooth. The removal was the only possible option.
Case #3 presented agenesis of the permanent upper canines (he never had them). Two premolars had to be extracted in the mandibular arch.
These cases thus show that it is possible to live without canines and have a functional occlusion.
Risks associated with an impacted canine
You must know that if you do not do anything and you keep your impacted canine, you are taking risks.
1- Formation of a cyst of the follicular envelope
A chronic apical lesion of the primary canine facilitated the development of a follicular cyst and the exaggerated movement of the permanent tooth #13.
This exaggerated upward and forward movement of the impacted canine makes the de-impaction treatment more difficult and longer.
2- Radicular resorption of permanent incisors
Incisors can suffer from resorption of their root. Note that the central incisors lost at least 50% of their length because of the impacted canines. Figuratively, we could say that there was a collision between the canine and the root of the incisor and the root “disappeared”.
In that case, we decided to extract the impacted canines, because it would have been impossible to perform the traction of these canines without causing more damage to the roots of the incisors.
This patient was lucky, because sometimes, one or more incisors need to be extracted like in this other case shown on the right.
3- Ankylosis of the impacted tooth
This problem was shown and discussed in the previous section. In such case, the removal of the ankylosed tooth is part of the solution.
This is just a brief summary of what can happen with an impacted canine. I did not describe every risk. It would be too long doing so.
Going back to your case, I want to understand that you do not want any surgery. But you will have to assume the risks and complications which will inevitably occur because of your decision.
Between two evils, you have to choose the lesser one. Undergoing a surgery to ligature an impacted canine is much better than any risks that you could face if you do not do anything.
You can live without canines if you do not have them, but you should not live with an impacted canine if you have any.
Think about it and make the right decision.