After your child has lost one or more of their baby teeth and the tooth fairy has collected them, the next step is to wait for the arrival of their adult teeth. In some cases, you may even see part of their permanent teeth starting to erupt before their baby teeth have completely fallen out. But, what about if one or more permanent teeth are not coming in? In most cases, you can expect to see your child’s permanent tooth erupting no later than six months after the primary tooth was lost. In rare cases, it can take as long as a year. There are some cases where your child’s permanent teeth may not erupt properly. Here are some of the reasons why:
Not Enough Space
One of the most common reasons that permanent teeth do not erupt properly is because there is not enough space for them. Since permanent teeth are wider than baby teeth, it is natural for baby teeth to have gaps between them. However, in cases where there are no gaps between the baby teeth, the permanent teeth may not have enough space to erupt into.
When a permanent tooth is unable to erupt it can be known as impacted. Impacted teeth are those that develop completely underneath the gum line. Impaction can occur as a result of narrow jaws, prematurely lost baby teeth, or a lack of space. In cases where impacted permanent teeth are unable to erupt due to a lack of space, orthodontic treatment is generally required to make more space in the mouth. Then, the impacted tooth is usually uncovered and gently pulled into place over time with orthodontic appliances.
Growing the Wrong Way
In some cases, a permanent tooth may not erupt because it is growing in the wrong direction. When this happens, it is generally either the lower second bicuspids or the upper canines. Usually teeth that are growing the wrong way require orthodontic treatment to help redirect them and allow them to erupt properly.
Too Many Teeth
Another possible reason that permanent teeth are not erupting is due to hyperdontia. Hyperdontia is a condition where extra teeth can develop known as supernumerary teeth. These extra teeth can block permanent teeth from erupting and can also cause overcrowding, displacement, and impacted teeth. To create more space in the mouth and prevent overcrowding, your child’s pediatric dentist may recommend extracting the extra teeth. Following up with an orthodontist may also be recommended.
There are certain medical conditions that affect the growth and development of the bones, which can result in the eruption of permanent teeth being delayed. These conditions include: rickets, hypothyroidism, fibrous dysplasia, and Down’s syndrome. In these cases, your dentist may simply choose to observe the tooth before making any treatment decisions.
If it has been six months or longer since your child has lost a tooth and there is no sign of a permanent tooth erupting, it is strongly recommended to visit their pediatric dentist. Although it can take up to a year for permanent teeth to erupt, this is not the norm and it is important to allow your child’s pediatric dentist to evaluate them for any possible complications.
Dr. Marielena Torres is board certified and is constantly continuing her education to stay informed of the latest developments in pediatric dentistry. This allows her to offer patients and their parents the most cutting-edge care and education.