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One of the most common reasons why we like to see children for their first orthodontic exam at age 7 is to evaluate the position of the developing upper permanent canines. We normally want and expect them to be developing straight up and down. This means there is generally enough space for them and they are “growing” in the correct position. With time we would expect them to “push out” the baby canines.

However, many times when we take the initial panoramic x-ray we observe that the upper canines are growing on an angle. This generally means there is not enough space for them and/or they are developing in the wrong area. Often they are overlapping the adjacent tooth (upper lateral incisor).

upper lateral incisor

This is an unfavourable situation for two main reasons: 1) The canine can cause damage to the root of the adjacent tooth (called root resorption), and 2) The canine can get stuck on the palate (become impacted). Teeth with resorbed roots have a worse long term prognosis. Impacted canines require a special surgery called an exposure and extensive and prolonged orthodontic treatment.

 

Luckily, impacted canines can be preventable if caught early enough. There are a number of approaches but usually the simplest one involves early removal of the upper baby canine. By doing this, it allows the permanent canine to redirect and change its position. Research has shown that extracting the baby canine results in successful eruption of the permanent canine approximately 80% of the time. Being slightly more aggressive and removing the baby canine AND first molar results in successful eruption of the permanent canine nearly 100% of the time.

The example below demonstrates this. Notice how the upper left canine is completely overlapping the root of the lateral incisor but after the extractions completely uprights.

upper lateral incisorupper lateral incisor

You may ask – what if we do nothing and just monitor? The same research study showed that doing nothing resulted in spontaneous improvement about 35% of the time. So it’s possible that it may improve and self-correct but it’s risky.

Another related question we get is: “If we just wait won’t the adult tooth just push out the baby tooth?” The answer to this question is that the natural mechanism of an adult tooth pushing out a baby tooth isn’t happening in this situation. That is why we are trying to restore normal by taking out the baby canines early. Usually extractions are done bilaterally. If done on one side, everything shifts over to the one side which can make the problem worse.

Further, there are other ways to make space for the canines – this involves doing an early round of orthodontic treatment including a palatal expander. This is usually the second line of defense or done from the outset if the upper canine is in a really bad position.

If you have questions about your child’s oral development, we are here to help! Contact the Walt Orthodontics office for a personalized consultation. We work with children, teens and adults in Vaughan, Maple and Thornhill!

LendCare

When it comes to financing there’s no one size fits all solution. Likewise, there is no singular solution when it comes to financing. At LendCare, we get that and go deeper to understand your unique story and offer flexible options that work best for you, given your current financial situation. That means you get affordable financing, even if your credit is anything but top-tier.

Walt Orthodontics is pleased to offer interest-free payments up to 30 months. If you require payments over 30 months we are happy to offer the LendCare solution.

DR. WALT’S DECISION TO BECOME AN ORTHODONTIST WAS INSPIRED BY HIS OWN DIRECT PERSONAL EXPERIENCE.

Dr. Walt received his dental (DDS) degree from the University of Western Ontario, graduating first in his class and receiving the Gold Medal as well as numerous awards recognizing his scholastic and clinical achievements, leadership and character. He then completed his orthodontic training at the University of Colorado, where he received both his Specialty Certificate and Master of Science Degree. During his residency, he was awarded the Rocky Mountain Orthodontics Scholarship for overall excellence.

After graduating from residency and opening Walt Orthodontics in 2013, Dr. Walt committed himself to applying his traditional orthodontic education into the digital world to improve clinical outcomes and patient experience. He currently serves as a Faculty Member, Key Opinion Leader, and Advisory Board Member for Align Technology which involves traveling around the world to teach other orthodontists about Invisalign. Being at the forefront of digital orthodontics, Dr. Walt was invited to be the first orthodontist in Canada to use custom LightForce braces. He also serves as an Orthodontic Coach/Mentor for other orthodontists looking to improve their knowledge of digital orthodontics.

In addition to practicing orthodontics, Dr. Walt is a “die-hard” Blue Jays fan and enjoys working out in his spare time.

DR. GROSSMAN STRIVES TO PROVIDE THE HIGHEST STANDARD OF ORTHODONTIC CARE FOR HER PATIENTS.

Dr. Stephanie Grossman pursued her dental degree in sunny South Florida at Nova Southeastern University. She graduated with honours, at the top of her class, and was inducted into the Phi Kappa Phi Honour Society. She then completed her orthodontic training at the University of Detroit Mercy, where she received both a Specialty Certificate in Orthodontics and a Master of Science degree. She is both a diplomate of the American Board of Orthodontics and a Fellow of the Royal College of Dentists of Canada.

Dr. Grossman strives to provide the highest standard of orthodontic care for her patients. She attends numerous hours of continuing education and utilizes the latest advancements in orthodontics. Dr. Grossman is licensed to practice in both the United States and Canada.

Outside of the clinic, Dr. Grossman enjoys spending time with her friends and family and traveling the world. She is a self-proclaimed foodie and loves trying new restaurants!