Case Stories
Please submit your personal stories, with or without names. I think for whoever finds my website, it is
very useful to hear more stories from other people.
Submitted May 2018
My 15-year-old daughter has an impacted upper canine. Her baby tooth fell out in 5th grade. When it still hadn't come in a full year later, we got concerned. However, after repeated check ups with our orthodontist, we were told to keep waiting, and that he thought it would still move down. I became concerned another year later when it STILL hadn't come in, and I noticed the space closing up and getting smaller and smaller, which I assumed would make it even harder for that tooth to come in. I got a second opinion with a new ortho, who felt that braces should be put on her upper to teeth to allow for a larger space for that canine. The braces did their job, creating a nice larger gap rather quickly, but a year later, the tooth still hadn't erupted. Finally, the ortho suggested oral surgery to attach a chain and begin traction. Unfortunately, after surgery, due to our schedule and the fact that our ortho was out of town for two weeks, we didn't begin traction for three weeks. At the time, I was uneducated about all of this and didn't realize the negative impact this can have on the outcome of the procedure. I now believe that this long delay without traction caused the tooth to become partially ankylosed. After almost 8 months of no eruption, our ortho suggested we go back into surgery and have the oral surgeon remove some of the gum and expose the canine. After this procedure, we noticed some movement, though minor. Many months later, the movement stopped, and we began to notice that the two teeth next to the canine (her front teeth) were starting to cant (move) upward, as if the force of the traction from the impacted canine was pulling them upward. At this point, I went and got a second opinion from another orthodontist, who told us this was sometimes seen, and not to worry, that the teeth would move back down after the canine moved down. Many more months later, and as our daughter began 9th grade, our regular orthodontist recommended a new treatment he'd heard about at a conference--Apicotomy. I read all about the procedure and the case studies and we felt this was the best course of option at this point, since our next option was to extract and move over the pre-molar into the canine's position, since there wasn't enough bone in the canine position. Our ortho and the oral surgeon collaborated quite a bit about the procedure, and with hopeful hearts, we sent out daughter off to another surgery. After 8 months, we've seen only very minor movement, and even with that, we can't quite tell if it is the tooth moving down, or the teeth next to it moving upward. We are at a point of having to decide our next step. We are so disheartened with our options, and my daughter is so tired of braces and having a hole in her mouth. With as many people who have impacted canines, you would think by now they'd have better solutions and treatments!
Hi. I stumbled upon your website today and wanted to write you to express my gratitude for all the information you have compiled. I am still reviewing your posts, and also following your son’s case. I too have an impacted canine. I am a 34y/o male patient in NY undergoing treatment with orthodontics and soon to have an impacted upper right canine exposed/bracketed.
I want more than anything to have my canine tooth brought in so that for once in my adult life, I can smile without being self-conscious. I am very disappointed with how uncoordinated my care has been so far. In trying to get out ahead of possible complications, I have done a lot of research, and sought several opinions among orthodontists and oral surgeons. The opinions have varied widely with regards to success rate for my particular situation, with orthodontists/oral surgeons saying there’s a 50/50 change of ankylosis of the tooth, among other potential complications. My feeling is that every orthodontist wants to give it a go in treating impaction, but very few take the time to understand this condition enough to have an initial treatment approach that provides a better success rate. Many I’ve consulted with appear to have outdated approaches, are uninformed about success rates for various approaches, or never mentioned workarounds to ankylosed tooth such as cutting bone around or auto-transplantation.
None of the doctors were able to adequately use the 3D scan in front of me to demonstrate my treatment options or to justify their approach or medical opinion. My orthodontist and one oral surgeon didn't appear to know what to do with a CBCT I got – painful to watch them having a hard time opening up the imaging software and properly navigating the 3D images, or to tell me on the spot whether my impaction was buccal or palatal, if the tooth was healthy, of deep or angled the impaction and how this correlates to treatment outcomes.
There was disagreement between my previous oral surgeon and my orthodontist on whether I needed a bone graft at the site of the impacted canine. At one point my previous oral surgeon and my orthodontist discussed my case, but when I spoke with each independently a few weeks later, they both had different next steps. I was furious and told that oral surgeon I was moving on, and threatened my orthodontist to properly document his communication with my future surgeon and pay attention to detail with my case. He has since been handling things better.
I have no way of comparing orthodontists'/oral surgeons’ competence, knowing if they are doing the right things or have the right expertise or treatment plan outlined to get my treatment right the first time. But I have already spent close to $7000 out of pocket with no insurance coverage for anything due to my age.
Another thing that frustrates me is that I have known about my impacted canine since I was 15 from a regular dentist checkup, but that office never referred or to told me I needed to do anything about it. This is when the issues could have been treated a guaranteed successful outcome. Would have been cheaper to too. I had no idea that a missing canine in the arch would cause bite issues, jaw development issues, shifting of my teeth to close the gap, midline shift, and chewing problems. How could my dentist fail me so much as a child.
Today, I can only hope to have my issue corrected. As someone who has had a difficult childhood, and today a financially difficult life, I have to endure something much more complicated because it wasn't given attention when it would have been easier to fix. In any event, I appreciate your website, I wish your son much success in his journey, and you are teaching people through your website and your efforts to first and foremost, be self-advocates in a crazy medical service world. Best regards!
I want more than anything to have my canine tooth brought in so that for once in my adult life, I can smile without being self-conscious. I am very disappointed with how uncoordinated my care has been so far. In trying to get out ahead of possible complications, I have done a lot of research, and sought several opinions among orthodontists and oral surgeons. The opinions have varied widely with regards to success rate for my particular situation, with orthodontists/oral surgeons saying there’s a 50/50 change of ankylosis of the tooth, among other potential complications. My feeling is that every orthodontist wants to give it a go in treating impaction, but very few take the time to understand this condition enough to have an initial treatment approach that provides a better success rate. Many I’ve consulted with appear to have outdated approaches, are uninformed about success rates for various approaches, or never mentioned workarounds to ankylosed tooth such as cutting bone around or auto-transplantation.
None of the doctors were able to adequately use the 3D scan in front of me to demonstrate my treatment options or to justify their approach or medical opinion. My orthodontist and one oral surgeon didn't appear to know what to do with a CBCT I got – painful to watch them having a hard time opening up the imaging software and properly navigating the 3D images, or to tell me on the spot whether my impaction was buccal or palatal, if the tooth was healthy, of deep or angled the impaction and how this correlates to treatment outcomes.
There was disagreement between my previous oral surgeon and my orthodontist on whether I needed a bone graft at the site of the impacted canine. At one point my previous oral surgeon and my orthodontist discussed my case, but when I spoke with each independently a few weeks later, they both had different next steps. I was furious and told that oral surgeon I was moving on, and threatened my orthodontist to properly document his communication with my future surgeon and pay attention to detail with my case. He has since been handling things better.
I have no way of comparing orthodontists'/oral surgeons’ competence, knowing if they are doing the right things or have the right expertise or treatment plan outlined to get my treatment right the first time. But I have already spent close to $7000 out of pocket with no insurance coverage for anything due to my age.
Another thing that frustrates me is that I have known about my impacted canine since I was 15 from a regular dentist checkup, but that office never referred or to told me I needed to do anything about it. This is when the issues could have been treated a guaranteed successful outcome. Would have been cheaper to too. I had no idea that a missing canine in the arch would cause bite issues, jaw development issues, shifting of my teeth to close the gap, midline shift, and chewing problems. How could my dentist fail me so much as a child.
Today, I can only hope to have my issue corrected. As someone who has had a difficult childhood, and today a financially difficult life, I have to endure something much more complicated because it wasn't given attention when it would have been easier to fix. In any event, I appreciate your website, I wish your son much success in his journey, and you are teaching people through your website and your efforts to first and foremost, be self-advocates in a crazy medical service world. Best regards!
Hi, my name is Danica and I am 20 years old. I came across your website whilst researching my orthodontic treatment. Here is my story...
When I was 11 years old my dentist referred me to a local orthodontist as my upper right #3 (canine) had not errupted. Upon xray this was confirmed. I was referred for an operation to expose the area to encourage the tooth, this just healed back up and was a pointless procedure. I went back for my appointment and he sent me for another operation to attach a chain to the impacted tooth and to have my braces hooked to the chain. Within a week this chain slid out whilst brushing my teeth. I went back for my third operation but this time decided on local anaesthetic. They repeated the operation. They also took out back teeth to make room for my orthodontic treatment. I returned to my ortho appts every month for the chain to be hooked on a tighter notch each time, this hurt so bad. My ortho was not compassionate and told me that the pain I said I was feeling was nonsense. After around 5 months my mother was concerned as there still was no sign of the tooth and maybe an xray would be of reassurance that the treatment was infact working. Ortho refused xray as it was unneccassary exposure. My mothere was concerned as she had seen this problem when we had researched it online, he assured me there was 1 in so many chances of the tooth fusing to the bone and he could see the tooth so there was no issue. After 8 months or so I noticed that my bite had severely disappeared on my right side. My teeth looked like stairs. The left side was perfect, yet from my front right tooth over the teeth appeared to be disappearing into my gum. Also my back teeth had swung out to my cheeks. We were concerned and went back to the ortho who had been convincing me that these changes were normal but this time he shouted at his nurses and asked who had been seeing to me (to which we all replied - you have been!) he finally did an xray and was very concerned as the tooth had not moved. Instead of my canine coming down to the level of my other teeth, my teeth were moving up to meet the canine. He referred to another local health board maxillofacial department to take over my care. Upon my consultation they were severely worried and took over my care. They sent me for 3D images which confirmed my tooth was ankylosed (fused to the bone) so it was no wonder it hadn't budged. They operated to have this removed (the tooth wasn't kept as it had turned transparent due to it dissolving into itself) They gave me lower braces, power chain and rubber elastics to try and correct my jaw, this has made very little difference, they tried for around 2/3 years. Eventually threy confirmed there is nothing else they could do but I would have to have bridge for now and an implant when I was 20. I am now being assessed for one. I am grateful to the maxillofacial dept of Morriston, Swansea for all they have done but I will never have my teeth back straight to how they once were all because of the ortho I was under. I want to say my story so that anybody undergoing the same treatment can see what happened to me.