Letter to the Editor
Prevention of retained teeth of permanent maxillary canines in primary health care
Prevención de la retención dentaria de caninos superiores permanentes en la atención primaria de salud
Yudel García-Rosell1* 
https://orcid.org/0009-0005-8949-8793
Yordania Blanco-Ruiz2 https://orcid.org/0000-0002-8778-3516
1Especialista de Primer Grado en Estomatología General Integral. Profesor Instructor. Clínica Estomatológica Docente “Dr. Luis Páez Alfonso”. Ciego de Ávila, Cuba.
2Especialista de Primer Grado en Estomatología General Integral y Ortodoncia. Profesor Asistente. Clínica Estomatológica Docente “Dr. Luis Páez Alfonso”. Ciego de Ávila, Cuba.
* Corresponding author. Email: 
yudelg643@.gmail.com
Keywords: cuspid; impacted tooth; preventive health services; primary health care; primary prevention.
Palabras clave: atención primaria de salud; diente canino; diente impactado; prevención primaria; servicios preventivos de salud.
Received: 2024/10/11
Accepted: 2025/02/26
Published: 2025/03/13
Dear Editor:
Although canine impaction is asymptomatic, its aesthetic and functional complications are varied and severe: dental misalignment, alterations in facial symmetry, aesthetic changes in the lips, negative effects on phonation, and malocclusions. For this reason, stomatologists consider this condition a health problem and a challenge in practice(1)
In general, orthodontics and maxillofacial surgery specialists are the professionals who—within secondary health care—treat this condition. In this regard, Rivero-Pérez(2) emphasized the importance of interdisciplinary care for patients with retained canines in the upper jaw, although his approach focused on the secondary level. However, the clinical practice of the author of this letter shows that in primary health care this problem can be effectively addressed through appropriate preventive strategies and a comprehensive approach to both the condition and the patients.
Blanco and colleagues(3) described some aspects of adequate treatment of the oral space in patients with mixed dentition, to facilitate the eruption of permanent teeth. This may include early interventions to ensure proper dental alignment and avoid orthodontic problems. Although these authors suggested specific strategies to be implemented in primary health care, they cannot be considered a generalized practice in the country.
In the National Program of Stomatological Care for the Population(4) and in the book Stomatological Care for the Population under 19 Years of Age. Manual of Procedures(5) no primary preventive actions for malocclusions are mentioned. Nor are there protocols or health promotion guidelines from the first level of care that detail preventive procedures for the retention of permanent canines in the pediatric population.
Nevertheless, from primary care, basic and comprehensive general stomatologists can carry out health promotion and preventive actions. These may include: informing parents about the importance of specialized monitoring of the eruption of permanent canines, so that if the process does not start correctly it can be corrected in time; strengthening oral hygiene education within school health programs; and raising awareness of the importance of regular stomatological check-ups, including the use of panoramic radiographs when necessary(5)
If canine impaction is managed comprehensively from primary health care, by controlling the risk factors that influence its occurrence, the incidence of this health problem will be reduced.
1. De Salvo L. Protocol for the characterization of retained Canines by cone beam computed tomography. Rep Imagenol Dentomax [Internet]. Jun 2023 [cited 2025 Feb 4];2(1):[about 12 p.]. Disponible en: https://www.publicaciones.svrid.org.ve/index.php/rid/article/download/51/89/446
2. Rivero-Pérez O. Need for interdisciplinary management of patients with retained canines in the upper jaw. Arch méd Camagüey [Internet]. 2023 [cited 2025 Feb 4];27:e9669 . Disponible en: http://scielo.sld.cu/pdf/amc/v27/1025-0255-amc-27-e9669.pdf
3. Blanco-Ruiz Y, Espinosa-Morales L, Hernández-González LM. Retention of permanent canines as a problem in infantile and juvenile population. Medicent Electrón [Internet]. 2021 Jun [cited 2024 Feb 18];25(2):373-6. Disponible en: http://scielo.sld.cu/pdf/mdc/v25n2/1029-3043-mdc-25-02-373.pdf
4. Sosa M, Toledo T, Barciela MC, García M, Rojo M, Morgado DE, et al. Programa Nacional de Atención Estomatológica a la Población [Internet]. La Habana: Editorial Ciencias Médicas; 2017 [cited 2025 Mar 7]. Disponible en: http://www.bvs.sld.cu/libros/programa_nac_aten_estomatologia_poblacion/completo_prog._nac_atenc._estomat._poblc..pdf
5. Sosa-Rosales M, González-Reynaldo J, García-Jordán M, Peña-Ruiz T, Díaz-García M, Bess-Constantén S, et al. Atención estomatológica de la población menor de 19 años. Manual de procedimiento [Internet]. La Habana: Editorial Ciencias Médicas; 2018 [cited 2025 Feb 7]. Disponible en: http://www.bvs.sld.cu/libros/atencion_estomatologica_poblacionmenor_manualprocedimientos/atenc_estom_poblac_completo.pdf
6. Rodríguez-Díaz AM, Pérez-Alfonso A. La ortodoncia preventiva en Cuba. Jornada Científica XXXIX Aniversario del CIMEQ [Internet]. 2021 Mar 26 [cited 2025 Feb 4]:[about. 8 p.]. Disponible en: https://aniversariocimeq2021.sld.cu/index.php/ac2021/Cimeq2021/paper/viewFile/126/106
Conflicts of Interest
The authors declare no conflicts of interest.
Authors’ contribution
Yudel García-Rosell: conceptualization, research, resources, writing of the original draft, writing, review, and editing.
Yordania Blanco-Ruiz: data curation, formal analysis, resources, and writing, review, and editing.
Funding
“Dr. Luis Páez Alfonso” Teaching Dental Clinic, Ciego de Ávila, Cuba.
Esta obra está bajo una licencia internacional Creative Commons Attribution4.0/International/Deed.