My child’s big teeth aren’t coming in, what is going on?

Did your child lose a baby tooth months ago and the permanent tooth still hasn’t come in?

There are a few reasons why this happens, which we will discuss here.  But the best thing you can do is schedule a consultation with orthodontic specialist who will evaluate.  We recommend kids first visit at age 7 or 8 and you DO NOT need a referral from your dentist.  This visit is always complimentary in our office.

*Below I have highlighting the most common reasons your kids teeth are not coming in to their mouth

  1. Lack of space, or severe crowding is one reason why these teeth may not come in.

There must be adequate space for an adult tooth to erupt in to the mouth.  The adult teeth are wider than the baby teeth, which is why we like to see spacing in young kids who still have primary teeth.  This is surprising to parents whose child’s teeth looked great before the baby one fell out. Again, baby teeth shouldn’t look perfect, there should be space.  If there is not enough space, your child may require early orthodontic treatment to create space.

  1. An adult tooth may not come in is because it’s not in the right position.

If the tooth is heading in the wrong direction, it can require even further care later in life, which is why we recommend seeing an orthodontist at age 7 or 8.  There we will evaluate that all the teeth are developing in the correct position, and if they are not, we can make early adjustments.  In many cases, removing a baby tooth as soon as the problem is identified may help the tooth find its correct path. If the path doesn’t change, orthodontic treatment is sometimes required to create space and sometimes guide it into the right position.

  1. Some adult teeth do not develop

This is very common for the upper lateral incisors, the second tooth from the center.  It is also common for the lower second premolars.  Because the lateral incisors are an esthetic tooth, it is helpful to know they are missing to plan for the esthetic replacement.  I have seen cases where the baby teeth are pulled, not realizing the permanent teeth are not developing and these patients are left without these front teeth.  In these cases, we leave baby teeth for as long as possible.  We then make a retainer with fake teeth until the patient is ready for a more permanent replacement such as implants.

  1. More rare instances

Sometimes the tooth takes longer than expected and nothing is wrong.  In cases where baby teeth are extracted early due to trauma or decay, we often see a delay in eruption of this tooth, which is still considering “normal”.  There are more rare conditions such as ankylosis or primary failure of eruption.  I won’t go into these, but again, we just recommend visiting your orthodontist for an evaluation.

In summary, the best thing to do is have your child evaluated by an orthodontic specialist at the age of 7 or 8.  There is no referral needed, we do not charge for the visit, and we can ensure everything is there and erupting properly.  If things need to be addressed, we can discuss the best solution.  Early treatment is sometimes the best and easiest solution for certain cases; however, I will never push early treatment if it is not needed.  At the end of the day my job is to show you everything I see and give you my professional recommendations.

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