Canine teeth are the third teeth from the center of your mouth. Sharp-tipped and longer than adjacent teeth, they play an important role in chewing and tearing food. Their visible location at the front of the mouth means that they are also prominent in your smile.



Patients may require canine exposures if one or more of their canine teeth have not emerged properly from their gums. Dr. Israel Puterman conducts the surgery to help patients achieve a more cosmetically appealing appearance as well as to improve their comfort while eating. Without receiving care for these impacted teeth, it is also possible for patients to experience problems with the alignment of nearby teeth, discomfort, pain, or even loss of adjacent teeth.

The Purpose of Canine Exposures

Typically, the canine teeth erupt from the gums when children reach 12 years of age. However, canines are the second most likely teeth to become impacted, following only the third molars (“wisdom teeth”). When this happens, the canines cannot fully emerge from the gums and may grow in the wrong direction or position.

Orthodontists in Bethesda typically refer patients to Dr. Puterman to have canine exposures because they want to prevent complications from impacted teeth and to allow for proper tooth arrangement. If left untreated, impacted canine teeth can cause:

  • Problems with the alignment of neighboring teeth.
  • Root resorption.
  • Infection or cyst formation.
  • Tooth sensitivity or pain.

Canine exposures give the impacted teeth a way to emerge from the gums. Unlike wisdom teeth, canines are valuable for both aesthetic and functional reasons. This procedure allows patients to keep their teeth rather than having them extracted.

Dr. Puterman performs canine exposures in coordination with orthodontists. After he conducts the surgery, the orthodontist can use special brackets and wires to guide the exposed canine teeth into their proper places. The result is a complete smile with even and well-aligned teeth. 

How Canine Exposures Work

Usually, an orthodontist will recommend that a patient see Dr. Puterman to get treatment for their impacted canine teeth. Parents will typically bring in their children aged 11-15 to Dr. Puterman’s practice for an initial consultation. Canine exposures are a well-established and straightforward procedure, and parents and patients can expect an effective and aesthetically appealing outcome.

During the consultation, Dr. Puterman will:

  • Take a 3D scan to precisely locate the impacted canine teeth. This will show him their position, orientation, and other features that may affect his approach.
  • Explain treatment with canine exposures to patients and parents and answer any questions they may have.
  • Discuss how he will work with their orthodontist to complete the treatment.

Once Dr. Puterman determines that canine exposures are the right option for the patient, families will schedule an appointment for the surgery. During the procedure, Dr. Puterman will make an very small incision to access the canine tooth and place an orthodontic bracket on it. A week or two afterwards, the patient will visit the orthodontist, who will use that bracket to bring the tooth into position over time.

What Patients Can Expect with Canine Exposures

Canine exposures are very conservative procedures. Dr. Puterman can typically complete the surgery within 20 minutes and patients can also choose to sleep through the entire experience.

Since patients are usually children or teens, parents often have questions about when to plan the procedure based on their school or summer schedule. They also want to know what the recovery will be like and how to support their child in the process. Here are some guidelines:

  • Most of Dr. Puterman’s patients who have canine exposures will experience minimal discomfort after the procedure. They usually will not need major medication to manage pain.
  • If patients are feeling up to it, they can go to school or return to normal activities the day after the procedure.
  • Patients should typically wait a week or two until they return to the orthodontist for treatment. This will give the surgical site time to heal and allow the orthodontist to have a clearer picture of the procedure’s outcome.

As with other teeth that an orthodontist treats, the pressure that the bracket and wire will apply should move the exposed canine into position over time. The orthodontist should be able to provide more guidance about the length of time this will take, which will vary by patient.

One of the most important aspects of canine exposures is ensuring that the bracket is sturdy and that it is placed in the right location. Orthodontists frequently refer patients to Dr. Puterman because of the success that he has had in establishing effective, lasting, and secure brackets. This lets orthodontists complete treatment more quickly, and it helps patients avoid unnecessary follow-up procedures.

Learn more about how Dr. Puterman cares for his patients and about the canine exposure procedure. Families can schedule an appointment online or by phone at (301) 652-0939.