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Buccal Ectopic Canine Management — ORE Part 1 MCQ

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ModerateOrthodonticsBuccal Ectopic Canine ManagementORE Part 1

A 12-year-old patient has a retained upper right deciduous canine. The upper right permanent canine is palpable high in the buccal sulcus above the lateral incisor root. Parallax radiographs confirm that the permanent canine is buccally impacted. What is the most appropriate initial management in primary dental care?

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Correct answer: D — Refer for orthodontic assessment without extracting the deciduous canine

**A is correct.** Accurate radiographic localisation has shown a **buccally impacted** canine. SDCEP advises that, in this situation, the retained deciduous canine should **not** be extracted routinely in primary care and the patient should be referred for orthodontic assessment. This allows assessment of arch space, canine position and the risks to adjacent incisors before a definitive plan is made. **B** is tempting because primary-canine extraction can be an interceptive measure in selected ectopic cases, but SDCEP reserves this primary-care approach for a canine that is **in the line of the arch but failing to erupt** in a 10–13-year-old. **C** and **D** unnecessarily sacrifice permanent teeth. **E** risks delaying assessment of an impacted tooth and potential damage to adjacent roots.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP), Oral Health Assessment and Review: Full Guidance, section “Ectopic or Displaced Canines”, May 2012. https://www.sdcep.org.uk/media/sy2ldxp2/sdcep-ohar-version-1-0.pdf