Baby teeth, also known as primary or deciduous teeth, serve several purposes in a child’s early development. They are crucial for proper chewing, aiding in nutrition, and supporting speech development. These initial teeth also hold the necessary space in the jaw for the permanent teeth that will eventually replace them. They also guide the eruption path for the adult teeth.
The Normal Journey of Teeth
The typical process of tooth replacement begins as children approach school age, usually around six or seven, continuing until 12 or 13. Permanent teeth develop within the jawbone beneath the baby teeth. As these permanent teeth grow, they exert pressure on the roots of the baby teeth. This pressure triggers root resorption, a natural process where the baby tooth’s roots gradually dissolve.
As roots resorb, the baby tooth loosens and falls out, making space for the permanent tooth. The shedding sequence often mirrors initial eruption, with lower front teeth typically going first. This natural shedding ensures a smooth transition to adult teeth.
Why Some Baby Teeth Linger
Sometimes, baby teeth do not fall out as expected, a condition known as retained primary teeth. Several factors can cause this deviation from the normal shedding process. One common reason is hypodontia, the congenital absence of a permanent tooth. If no adult tooth forms beneath a baby tooth, there is no pressure to resorb its roots, allowing the baby tooth to remain in place.
Another cause is impaction, where a permanent tooth is present but unable to erupt due to being blocked or growing in an unusual position. This can occur if the permanent tooth is misaligned or if there isn’t enough space in the jaw for it to emerge. In such cases, the permanent tooth cannot exert the force needed to dissolve the baby tooth’s roots, leading to retention.
Ankylosis is a condition where a baby tooth’s root fuses directly to the jawbone, preventing its natural loosening and shedding. This fusion occurs if the periodontal ligament, which connects the tooth to the bone, is compromised. An ankylosed tooth may appear shorter than neighboring teeth because it doesn’t continue to emerge as the jaw grows. Additionally, a lack of sufficient space or crowding can also contribute by preventing proper permanent tooth eruption.
Living with Lingering Baby Teeth
When baby teeth remain into adulthood, various implications can arise. A retained baby tooth is often smaller than its permanent counterparts, potentially leading to aesthetic concerns or gaps between teeth. This size discrepancy can also affect how upper and lower teeth meet, creating bite issues or malocclusion. Uneven bites can lead to excess force on certain teeth, potentially causing damage.
Retained baby teeth may also be more prone to decay and gum disease. Their enamel is not as strong or as thick as that of permanent teeth, making them more susceptible to cavities. If left unaddressed, decay in retained primary teeth can increase the risk of infection and periodontal disease. The continued presence of a baby tooth can also lead to diminished bone support in the area or cause adjacent permanent teeth to shift out of alignment.
When to Consult a Dentist
If a baby tooth does not fall out around the expected age, or if a permanent tooth appears to be delayed, seeking a dental evaluation is advisable. A dentist can perform a comprehensive examination, often including X-rays, to determine the reason for the retention. X-rays help identify whether a permanent tooth is present beneath the baby tooth, its position, and if there are any underlying issues like impaction or ankylosis.
Depending on the diagnosis, management approaches vary. In some instances, if the retained baby tooth is healthy and causes no problems, it may be monitored. However, if the tooth is causing issues like crowding, bite problems, or is susceptible to decay, extraction might be recommended. Orthodontic treatment, space maintainers, or future prosthetic options like implants or bridges, in cases of missing permanent teeth, may also be considered to ensure optimal oral health and function.