When a tooth does not emerge as expected or stops its development, it can be a source of concern. The process of tooth formation and eruption is intricate, involving a series of biological steps that can sometimes be interrupted. Understanding the underlying reasons for such an occurrence can help individuals know when to seek professional guidance.
How Teeth Normally Grow
Tooth development begins long before birth, with specialized cells forming tooth buds within the jawbones. These buds eventually differentiate to form the crown, the visible part of the tooth, which calcifies first. Following crown formation, the roots begin to develop, anchoring the tooth into the alveolar bone. As the root lengthens, it pushes the tooth through the gum tissue in a process known as eruption. This process continues until the tooth reaches its functional position in the mouth, aligning with opposing teeth.
Reasons a Tooth Stops Growing
A tooth may fail to grow or erupt for several distinct reasons, often stemming from issues during its developmental pathway. One common cause is impaction, where a tooth becomes physically blocked or misaligned, preventing it from breaking through the gum line or bone. This can occur if there is insufficient space in the jaw for the tooth to emerge, or if the tooth is angled abnormally, such as a horizontally positioned wisdom tooth.
Another reason a tooth might not appear is agenesis, also known as hypodontia, meaning the tooth never formed. This condition involves the congenital absence of one or more teeth, resulting from a failure of the tooth bud to develop. Ankylosis occurs when the tooth’s root fuses directly to the surrounding bone, preventing its natural movement and eruption. This fusion eliminates the periodontal ligament, the cushioning tissue that normally connects the tooth to the bone, halting its upward progression.
Physical obstructions can also impede tooth growth, including cysts, benign tumors, or supernumerary teeth, which are extra teeth that occupy the space intended for normal dentition. Trauma to the jaw or an existing primary tooth during childhood can damage the underlying permanent tooth bud, disrupting its development. Genetic factors also play a role, with certain inherited conditions like Ectodermal Dysplasia affecting tooth formation and eruption patterns.
Recognizing the Issue and Getting a Diagnosis
Recognizing that a tooth has stopped growing often involves noticing a gap in the dental arch where a tooth should have emerged by a certain age. Parents might observe a delay in eruption compared to other teeth or their child’s peers. Persistent pain or discomfort in the jaw area where a tooth is expected can also be a sign of an underlying issue, particularly with impacted teeth.
Consulting a dentist or orthodontist is a necessary step when concerns about delayed tooth eruption arise. Dental professionals will perform a visual examination of the mouth to assess for missing teeth or abnormalities. Diagnostic imaging, such as panoramic X-rays or cone-beam computed tomography (CBCT) scans, provides detailed views of the jawbones and unerupted teeth. These images help determine the tooth’s position, orientation, and developmental stage, and identify any obstructions or underlying conditions like agenesis or ankylosis.
Resolving a Stalled Tooth
The approach to resolving a stalled tooth depends on the specific cause and the tooth’s condition. In some mild cases, if a tooth is slightly delayed and not impacted, a dentist might recommend monitoring to see if it erupts naturally. This observation period allows for natural eruption, avoiding immediate intervention.
For healthy impacted teeth, surgical exposure and orthodontic eruption are common solutions. This procedure involves a surgical opening of the gum and sometimes bone removal to expose the crown of the impacted tooth. Subsequently, an orthodontic bracket may be bonded to the exposed tooth, allowing an orthodontist to guide it into position with braces. If a tooth is severely impacted, ankylosed, or causing damage to adjacent teeth, extraction may be the option to prevent complications.
When a tooth is congenitally missing (agenesis) or has been extracted, replacement options restore function and aesthetics. Dental implants, artificial tooth roots placed into the jawbone, offer a durable and natural-looking solution. Fixed bridges, using adjacent teeth as anchors, can also fill the gap. A removable partial denture is another option.