Eight-year-old Lost Permanent Tooth

My eight-year-old son just called me to say that he lost a permanent tooth (front). Being permanent, I suppose another growth would be impossible; does it mean dentures for this? When and what would be the best course of action for me?

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First, your son should see a dentist for a radiograph (x-ray) of the area to help ensure that this was indeed a permanent tooth which was lost. Even at eight years of age, this could be a primary tooth. The average age that upper front primary teeth are lost is between 7-8 years old. If it was a permanent tooth, it is highly unlikely that your son will grow another one. There have been extremely rare cases in which people have developed a third set of teeth.

Given your son's age, there are not many options for replacing the tooth at this time. One option is to have the dentist fabricate a stayplate. A stayplate (also known as a "flipper") is a temporary partial denture which can replace the missing tooth until your son is older, and the nerves in his teeth have had more time to develop. Another option is to construct a Maryland Bridge. This appliance differs from a conventional bridge in that the teeth on either side of the missing tooth (abutments) are not prepared for full crowns, which hold the false tooth between them. In fact, a very small amount of tooth structure from the abutment teeth is removed for a Maryland Bridge when the bridge is bonded into place. The main disadvantage of the Maryland Bridge is that they do have a tendency to come loose. A Maryland Bridge or even a conventional bridge is definitely not an option if either abutment tooth is a primary tooth. A conventional bridge will not become an option for about 5-6 more years when the nerve tissue in the teeth is more developed.

When your son is older, probably about 18 years old, an implant might be another option for replacing the missing tooth. It is necessary to wait for the implant because complete eruption of the teeth, and the majority of growth must be completed to help ensure success of the implant. In addition, the bone must be a certain density for the implant. Young bone is less dense than older bone. Thank you for your question and good luck.

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