Displaced tooth?

My 5 year old had perfect teeth until recently. Her lower front tooth became loose after "accidentally" chewing on a piece of hard meat. This caused her gum (where the tooth is) to swell slightly and left her lower teeth "not aligned". The swelling has subsided but left the tooth out of position. Will her permanent tooth later grow at this position? My daughter is clearly worried as she feels "funny" with this tooth out of position.


Dear Rozie,

The displacement of the primary tooth does not necessarily mean the permanent tooth will also be malaligned. If the permanent teeth are malaligned, it is most likely that there is a skeletal or tooth malalignment which would have existed despite the trauma to the primary tooth.

The primary tooth should be regularly monitored, however, because changes in the tooth due to the trauma may be noted. These changes include possible pulpal (nerve and blood vessel in the tooth) necrosis, which could cause possible pain and/or infection. If pain or swelling occurs, the dentist should examine and treat the area as soon as possible. While the tooth may be saved by performing a pulpotomy or pulpectomy, extraction may be a better option if the tooth is close to falling out naturally. In addition, the occlusion (relationship of upper and lower teeth) should be evaluated because the tooth may be occluding prematurely. This prematurity should be adjusted to avoid pain or further trauma to the tooth.

It sounds as if this trauma probably did not cause damage to the developing permanent tooth underneath it, but you should be aware that certain conditions may be a possibility. A small defect in the enamel of the permanent tooth may appear as a rough, yellow-brown, malformed area or as a small white or yellow spot in the enamel.

Basically, you should reassure your daughter that it is unlikely her permanent tooth will erupt in the same, malaligned position as her primary tooth. Even if her permanent teeth do erupt out of alignment, orthodontics will help straighten them. In addition, she is likely to loose that primary tooth within the next year or two. Careful monitoring by your dentist should also be done to assess any changes in the area

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