Prevalence and Patterns of Canine Impaction Among Orthodontic Patients in Brunei Muara: A Cross-Sectional Study
This cross-sectional study conducted at the National Dental Centre in Brunei Darussalam from 2022 to 2024 determined a 5.3% prevalence of canine impaction among orthodontic patients, revealing a higher incidence in the upper left quadrant and significant variation in impaction subtypes by anatomical position, though no significant associations were found with age, gender, ethnicity, or malocclusion.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
In the landscape of human dentistry, there is a specific moment when a tooth is expected to make its way into the mouth, only to stop short and remain hidden within the jawbone. This condition, known as impaction, occurs when a tooth fails to emerge after its usual time has passed. While several teeth can be affected, the upper canine—the pointed tooth often called the "eye tooth" located at the corner of the smile—is the second most common tooth to get stuck, surpassed only by the wisdom teeth at the very back. When these canines remain trapped, they are not merely a cosmetic concern; they can disrupt the bite, damage the roots of neighboring teeth, and affect a person's confidence. Because the causes are complex and vary from person to person, understanding exactly how often this happens and in what patterns is essential for doctors to plan the right treatment. Without this knowledge, managing these cases becomes a matter of guesswork rather than precise care.
Researchers in Brunei Darussalam recently set out to map out this specific dental puzzle within their own community. They focused on the Brunei Muara district, examining the records of patients who had been referred to the National Dental Centre for orthodontic care between the beginning of 2022 and the end of 2024. By reviewing the digital files and X-rays of 419 individuals waiting for treatment, the team sought to answer three fundamental questions: how common is this problem in their region, does it happen more often in certain types of people, and where exactly do these teeth get stuck? The study looked at factors like age, gender, and ethnicity, as well as the specific shape of the patient's bite, to see if any of these details could predict the presence of an impacted canine.
The investigation revealed that canine impaction is a notable issue in this population, affecting 5.3 percent of the patients referred for orthodontic care. This means that out of every hundred people seeking help for their teeth, roughly five were dealing with a canine that had failed to erupt. The researchers found that this problem almost exclusively occurred in the upper jaw and, in every single case, it affected only one side of the mouth rather than both. Interestingly, the left side was more frequently affected than the right, with the upper left canine being the most common culprit. The study also looked closely at whether being male or female, being of a certain age, or belonging to a specific ethnic group made a difference. The data showed no such link; the condition appeared with equal likelihood across different genders, ages, and ethnicities, suggesting that these demographic factors do not drive the occurrence of the problem in this region.
Beyond simply counting the cases, the team examined the specific orientation of the trapped teeth to see if they followed a predictable pattern. They used two established systems to categorize the teeth based on their angle and position relative to the surrounding teeth. One of these systems, which divides the area around the canine into different sectors, showed a clear pattern: the majority of the impacted teeth were located in the sector closest to the front of the mouth. This specific positioning is significant because it often indicates that the tooth has a better chance of being guided into place if the baby tooth in front of it is removed early. However, the study also uncovered a rare and unusual occurrence. In two specific cases, the teeth were so misplaced that they did not fit into any of the standard categories. These teeth were found in a position where they had swapped places with the neighboring premolars, a rare anomaly that existing classification systems were not designed to describe.
The researchers also tested whether the overall shape of a patient's jaw or the way their teeth met together could predict an impaction. They compared the condition against various bite classifications, such as whether the jaws were aligned or if the teeth overlapped in specific ways. The results showed no connection; a person's bite type did not make them more or less likely to have an impacted canine. This finding challenges the idea that a specific malocclusion is a reliable warning sign for this condition. Ultimately, the study provides a clear snapshot of the situation in Brunei Muara, confirming that while the condition is relatively common, it does not favor any specific group of people. The work highlights the importance of early detection, particularly for teeth stuck in the front-most sector, while also noting that some cases are so unique that they fall outside the standard rules dentists usually rely on.
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