Disorders of the Cuspid Teeth

Canine Teeth Are Important for Eating and Speaking

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The maxillary cuspids are the two pointy teeth located next to the four front incisors. Jerome Tisne/Getty Images

The cuspids are among the most recognizable teeth in the mouth due to their pointed shape and extended length. Also known as canine teeth (or "fangs" or "eye teeth" if referring to the upper teeth), the cuspids are located between the incisors (the narrow-edged teeth at the front of the mouth) and the premolar teeth.

Role of the Cuspids

A person will typically have four cuspids: two upper (known as maxillary cuspids) and two lower (known as mandibular cuspids).

Used for the gripping and tearing food, cuspids are larger and stronger than the incisors with roots that sink deeply into the bones of the jaw.

Cuspids are usually the last of the front teeth to erupt, usually between the ages of 11 and 13. Their length paired with their single, anchored roots are central to the alignment of the bite. Any malformation or misalignment can interfere with eating and speaking.

There are two common orthodontic problems associated with the cuspids:

Impacted Cuspids

An impacted tooth is one that gets "stuck" and fails to erupt into its appropriate position. The maxillary cuspids are the second most common teeth, next to the wisdom teeth, to become impacted. If this happens, the tooth can begin to erupt either very high in front of the other teeth (in the so-called vestibular position) or behind the other teeth on the palate side (in the palatal position).

Treatment may involve the use of braces to open spaces and allow for proper eruption.

In other cases, oral surgery may be needed to remove any interfering teeth.

If performed when the cuspids are first emerging, there is every chance that the teeth will align on their own. If left untreated until an older age, the impacted tooth may end up getting fused into position and require extraction.

A dental bridge or implant would then be needed to fill the gap.

Gingival Recession

Gingival recession, commonly known as receding gums, can happen around any tooth but commonly affects the maxillary cuspids and the mandibular incisors. The condition is typically associated with aggressive tooth brushing, smoking, poor dental hygiene, and periodontal disease.

The condition may be caused, in part, by canines that have emerged misaligned. If the teeth are crooked, the gums can be stretched in opposite directions, causing the thinning of tissue and an increased vulnerability to injury. Moreover, the misalignment of the cuspids can make brushing difficult and lead to the buildup of tartar and the development of gum disease.

To repair the damage, orthodontic surgeons may turn to soft tissue grafting in which tissue is taken either from another part of your mouth or a donor and sutured into place over the area of tissue loss. In cases of advanced gum disease, a procedure called pocket depth reduction may be used to remove diseased tissue and allow for easier brushing and flossing to prevent further deterioration.

Sources:

Becker, A. and Chaushu, S. "Etiology of maxillary canine impaction: A review." Am J Ortho Dento Ortho. 2015; 148(4):557–67. DOI: 10.1016/j.ajodo.2015.06.013.

Pickron, R. "Etiology of gingival recession." Am J Ortho Dento Ortho. 2014: 146(6):693-4. DOI: 10.1016/j.ajodo.2014.09.018.

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