TOOTH ERUPTION AND ABSENCE

TOOTH ERUPTION

kurol_copyThe process of permanent tooth eruption resulting in the loss of primary (baby) teeth occurs through resorption of the primary tooth root as the permanent tooth erupts. Progressive eruption creates progressive resorption of the primary tooth root; which causes the tooth to become wiggly. Teeth should erupt in pairs, which should be within 6 months of each other. Delay, asymmetry and lack of space for an erupting tooth are examples that would warrant further investigation.

Earlier intervention of an eruption problem can significantly effect the success of a tooth erupting. The classic example being the impacted maxillary canine position relative to the lateral incisor root.

Image: Ericson S, Kurol J. Early treatment of palatally erupting maxillary canines by extraction of the primary canines. Eur J Orthod 1988;10:283-295.

TOOTH LOSS OR ABSENCE

missing_baby_tooth-1Ideally, a space resulting from tooth loss or absence should be closed orthodontically. This is not always practical nor esthetically pleasing; in these cases a restorative replacement may be an option and should be coordinated by your treating dentist. If an implant is chosen, consideration must be given to timing of treatment due to residual growth into the late teens to early twenties. An implant placed would display an esthetic difference in tooth height relative to the surrounding teeth if residual growth occurred. Also, consideration must be given to growth pattern and the ridge of gum tissue; it may be preferable to allow teeth to be guided into the space of a missing tooth to allow bone development, and then later move the tooth orthodontically.

Missing adult teeth are often seen in the lateral incisor position in the maxilla(upper jaw) and/or the 2nd premolar position. Missing baby teeth tend to mean that the adult tooth will also be absent as the adult tooth arises from the bud of the baby tooth. (See above image).

These opinions are meant for educational purposes and are in no way an exhaustive explanation of orthodontic diagnosis. Any suspicion of a condition mentioned should be confirmed with a certified specialist in orthodontics.

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