Wrongly Placed Canine & Painful Third Molar in 27-year Old

Wrongly placed upper canine — a big villain for shy smiles!

These are the dental photographs of a 27-year woman. She came to me with complaint of pain in the lower right third molar region. Oral examination revealed that a corner of this third molar can be felt with a dental instrument. But at 27 years of age, it is quite likely that it won’t erupt in her mouth.

Third molars normally erupt in the oral cavity in the age group 17-21years. After this time, there is usually lack of eruptive forces –which make the teeth erupt—and hence they don’t erupt fully in the mouth thereafter.

By the way, why this third molar did not erupt earlier? – The exact cause would be revealed after we do a dental x-ray. However, oral examination raises the suspicion that its location must not be right –it must be trying to come at a wrong position or there is possibility that there is lack of space to accommodate this erupting lower third molar. Hardly anything can be done for this wisdom tooth except its removal. For her acute pain she has been advised to take a pain-killer and frequent warm saline gargles also do help.

Her third molar on her left lower side is also partially erupted and partially covered with gum flap which is inviting food impaction. Such teeth quite often develop dental caries. Her upper third molars on both the sides are missing.

She has another problem of a malposed, labially placed upper canine. Because of this awkward-looking canine I noticed that she is not comfortable with her looks (read smile). Such teeth are bound to lead to development of some complex in the person. When I suggested to her to get it removed (she should have got it done years back!), she says her grandma is against any dental extraction. I told her to bring her granny to me so that I can make an effort to convince her in allowing dental extraction of a wrongly placed upper canine which would change her grandchild’s world! — when I say this, I mean it. People are so uncomfortable with their crooked teeth but won’t seek treatment due to 101 reasons and excuses.

Overcrowded Lower Teeth Leading to Tartar Deposits

Another issue with her teeth is overcrowding of lower front teeth as you can see in this photograph. I never suggested any solution for this problem – as it was never a problem for her. Of course, I advised her to get scaling done so that dental calculus deposits are removed. When she would come for that, I would motivate her to be much more meticulous with her tooth brushing in this lower front area as such overcrowding invites plaque deposits, calculus deposition, food impaction, gum swelling and of course, dental cavity. That means her visits to the dentist should be quite regular for looking out for early signs of any dental problem.

I don’t know whether she would listen to my advice!

Added two days later

Finally she must have got convinced with my advice.  She was my first patient yesterday. The wrongly positioned canine was removed in 2-minutes. Mostly it takes 15-20 seconds after local anesthesia has made the area numb, as in teenagers the bone is very soft and spongy. However, in a 27-year old as the bone is comparatively dense and compact, so it took 2-minutes of manoeuvring to take it out.

New look after removal of the malposed canine

Broad and confident smile!!

She had come for routine check-up today — she said she is greatly satisfied with her new look. But complained of pain in the extraction wound for which she has been advised to do lot of warm saline mouth rinses and using painkillers and anti-swelling tablets (like Ibuprofen and paracetamol tablets) for just 1-2 days after which there would be no pain, no discomfort …….just broad, confident smiles all the way!!


About drparveenchopra

Dr Parveen Chopra is Masters in Dental Surgery.. with 35 years of experience in dentistry. For trying his hand in health writing, he studied Communication for seven years. He is a blogger since 2007- he enjoys writing in conversational style.
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