Losing baby teeth and gaining permanent ones is a natural part of growing up. Most children begin this process around age six, continuing through their early teenage years. However, sometimes a baby tooth stays in place longer than expected, leading to questions about whether this is typical. Understanding the usual timeline helps identify when a retained baby tooth might indicate an underlying issue.
Understanding Typical Tooth Development
Tooth development starts before birth, with tooth buds forming for both primary (baby) and permanent teeth. Primary teeth typically begin to emerge around six months of age, with most children having a full set of 20 primary teeth by age three. These teeth are important for chewing, speech, and guiding the permanent teeth into their correct positions.
Around age six, the mixed dentition stage begins, where primary teeth start to shed and permanent teeth erupt. The first permanent molars usually emerge behind the primary teeth, not replacing any. This process generally continues until around 12 or 13 years of age, when the last primary teeth are lost. While most children lose their last baby tooth by age 12, some may retain baby teeth until age 13, particularly boys.
Common Reasons for Retained Baby Teeth
Several factors can cause a baby tooth to remain in place past the typical age. One common reason is the congenital absence of a permanent successor tooth, known as hypodontia or tooth agenesis. This means the permanent tooth never formed, so the baby tooth may not fall out without the pressure of a developing permanent tooth. Hypodontia is a common dental anomaly, affecting 2-7% of people, and is more frequent in girls. It can be influenced by genetic factors or environmental factors such as infections or trauma during tooth development.
Another cause is an impacted permanent tooth, where the permanent tooth is blocked from erupting properly. This can happen if the permanent tooth grows at an unusual angle, is obstructed by another tooth, or if there is insufficient space in the jaw.
Ankylosis is a condition where a baby tooth fuses directly to the jawbone, preventing it from loosening and falling out. This fusion stops the baby tooth from moving as the jaw grows, making it appear shorter or “submerged” compared to neighboring teeth. Trauma and genetic factors are considered risk factors. Ankylosis is more commonly observed in lower primary molars.
When to Consult a Dentist
If a 13-year-old still has baby teeth, it is advisable to consult a dental professional, such as a pediatric dentist or an orthodontist. A comprehensive dental examination, often including dental X-rays, can help determine the underlying cause of the retained tooth. Identifying the reason is important because retained baby teeth can lead to complications if left unaddressed.
Potential issues include misaligned permanent teeth, bite problems, crowding, or an increased risk of tooth decay in the retained baby tooth. Depending on the diagnosis, treatment options vary. These may include monitoring the tooth, extracting the retained baby tooth to allow the permanent tooth to erupt, or using orthodontic treatment to guide impacted teeth or address crowding. In cases where a permanent tooth is congenitally missing, the baby tooth might be retained for as long as possible, or options like dental implants or bridges may be considered in the future.