A tooth that will not come out can be a source of concern, whether it is a baby tooth that is loose but lingers or an adult tooth that has failed to emerge. While some situations might resolve with gentle at-home care, others require professional dental intervention. Understanding the reasons behind a tooth’s reluctance to erupt can help guide appropriate action.
Reasons a Tooth May Not Erupt or Come Out
A tooth might not erupt or fall out for several reasons, varying between baby and adult teeth. For baby teeth, a common cause is incomplete resorption of the root, meaning the root has not dissolved sufficiently for the tooth to loosen and detach naturally. Sometimes, the permanent tooth underneath may not be growing in the correct position to exert the necessary pressure for the baby tooth to fall out.
Adult teeth often face impaction, a condition where a tooth is unable to fully break through the gum line or jawbone. This can occur due to a lack of space in the jaw, as seen with wisdom teeth that are the last to emerge and often lack adequate room. Other causes for impacted adult teeth include growing in at an incorrect angle, overcrowding from existing teeth, or the presence of supernumerary teeth, which are extra teeth that block the eruption path. Trauma to the mouth can also sometimes delay or prevent a tooth’s eruption.
At-Home Steps for Loose Baby Teeth
For a baby tooth that is loose but not yet ready to come out, gentle at-home methods can often encourage its natural shedding. One safe approach is to encourage the child to gently wiggle the tooth with a clean finger or their tongue. This consistent, gentle pressure helps to further loosen the tooth without causing pain or damage.
Incorporating crunchy foods into the child’s diet, such as apples or carrots, can also assist in the process, as chewing can naturally help dislodge a very loose tooth. Maintaining good oral hygiene around the wobbly tooth is also important; regular brushing and flossing help keep the area clean and healthy during this transitional period.
Avoid forceful pulling, twisting, or using methods like tying string to the tooth, as these actions can cause unnecessary pain, bleeding, or damage to the gums and underlying permanent tooth. These at-home strategies are most effective when the baby tooth is already very loose, indicating that its root has largely dissolved.
Signs It’s Time to See a Dentist
Recognizing when professional dental intervention is necessary is important for both baby and adult teeth. For baby teeth, a dental visit is warranted if you observe:
Persistent pain, excessive bleeding, or swelling around the loose tooth.
Signs of infection, such as redness, pus, or a foul odor.
A permanent tooth beginning to emerge behind a baby tooth that is not yet loose (often called “shark teeth”).
A baby tooth remaining loose for several months without falling out.
For adult teeth, signs that suggest impaction or other eruption issues requiring professional assessment include:
Pain, swelling, or tenderness in the jaw or gums.
Difficulty opening the mouth fully.
Persistent bad breath or an unpleasant taste.
An expected permanent tooth not erupting by a certain age.
An impacted tooth causing damage to adjacent teeth or forming cysts.
A dental professional can conduct an examination, often including X-rays, to determine the appropriate course of action.
Professional Solutions for Stuck Teeth
When a tooth does not erupt or fall out naturally, dentists have several professional solutions. For baby teeth that are stubborn, a simple extraction may be performed, especially if the tooth is causing prolonged discomfort, infection, or obstructing the eruption of the permanent tooth. This procedure involves removing the remaining portion of a primary tooth, often when its root has largely resorbed and it is retained only by soft tissue.
For impacted adult teeth, the approach depends on the specific situation. If an impacted tooth, such as a wisdom tooth, is causing pain, infection, or damage to surrounding teeth, surgical extraction may be recommended.
This can range from soft tissue impaction removal, where the tooth is covered only by gum tissue, to more complex procedures for partially or completely bony impactions, which involve removal of bone to access the tooth.
In some cases, if the impacted tooth is a canine or another tooth that can be guided into place, a dentist might perform a procedure called exposure and bonding. This involves removing the gum and bone covering the tooth, and attaching an orthodontic bracket to help pull the tooth into alignment with braces.
Creating space through orthodontic treatment or extracting other teeth may also be necessary if overcrowding is preventing proper eruption.