Baby Teeth Aren't Falling Out!

My eight-year-old son's adult teeth erupt behind his baby teeth and do not push the baby teeth out. Every time an adult tooth erupts, we have to have the baby tooth extracted. When we are given his baby tooth, there is no resorption of the baby tooth root. Is this going to happen with all of his baby teeth? Is this unusual?

My daughter is six now and none of her baby teeth have become loose? What are the odds that she will be unlucky and have to have her baby teeth extracted too?

Question:

It is not uncommon for the permanent anterior teeth to erupt slightly behind the primary teeth, especially in the lower arch. In the majority of cases, the primary teeth are exfoliated (lost) without assistance from a dentist; however, there may be occasions when the root of the primary tooth is not resorbed. This type of eruption can sometimes be associated with spacing problems in the arch.

The posterior teeth are less likely to have this type of eruption pattern. Normally, the roots of the primary molar straddle the developing permanent premolar. Typically, there are three roots on an upper molar and two roots on a lower molar. As the permanent premolar erupts, the roots of the primary molars are resorbed, resulting in exfoliation. Occasionally, the permanent premolar may be slightly offset, causing difficulty in normal exfoliation. However, this is relatively uncommon in the posterior region.

Radiographs (x-rays) will help determine if the permanent teeth are properly positioned beneath the primary teeth. Keep in mind that a radiograph is a two-dimensional picture of a three-dimensional tooth. Accordingly, determination of a tooth's position relative to the midline of the mouth is easier than determining its facial-lingual (cheek to tongue) position when viewing an x-ray. If it appears that your son does have a lack of space for his incoming permanent teeth, a consult with an orthodontist would be prudent. Utilizing your son's growth potential to gain more space may achieve optimal tooth alignment.

It is difficult to predict if your daughter will have a similar situation. Even identical twins can have different oral conditions including tooth eruption patterns! Again, radiographs will help determine the stage of development and eruption of the permanent teeth. They will also show if the roots of the primary teeth are being resorbed by the permanent teeth. With this information, you and the dentist can plan ahead.

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