Those permanent canines, cripes!

You got to palpate those canine bulges 💪🏼

Around age 10 or 11, one should be able to palpate for the labial/palatal canine bulge in the upper arch. The concern here is possible canine impaction.

Check the following -

💪🏼 Canine bulge - should be palpable otherwise take radiographs to determine position of the upper canines.

🦷 Size of upper lateral incisors - small or peg shaped laterals are often associated with impacted canines.

📐 Angulation of upper lateral crowns - distal inclination of crown is preferable as canine would be more likely to descend along the distal aspect of the root.

Note the distal inclination of upper laterals - this is favorable to canine eruption in the attached gingiva.

🦷 Lower canine eruption - Usually erupt 6-9 months ahead of upper canines. If it has been 6 months or more since lower primary canines exfoliated, upper primary canines should start show some mobility.

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Q. Which radiographs to take?

Age 10-11 is a good time to take a PAN to locate the Maxillary canines. SLOB rule to determine labial or palatal impaction using two Periapicals or PA/PAN and an occlusal radiograph.

🔥 Labially impacted canines are more commonly seen in crowded arches, palatal ones in narrow arch with spacing.

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Risk factors for ectopic canines -

👨‍👩‍👧 Family history - ask the parents/siblings if their canines had to be surgically exposed and guided into position.

🦷 Small or peg shaped laterals

🔎 Missing laterals

🦷 Ectopic central incisors

🦷 Late or asymmetric eruption of canines

Early detection can minimize complications.