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Common Permanent Tooth Eruption Problems & Solutions

Butterfly On Little Girl's Nose
A child's entire set of permanent teeth, excluding their wisdom teeth, typically emerge between the ages of 6 and 12. If you have a child who is around the age of six, then you should start monitoring the eruption of their adult teeth to ensure these teeth appear healthy and are emerging on schedule.
If you do notice any problems with their permanent teeth, you can then notify their dentist, who can take steps to correct the problem and, if possible, take steps to encourage their remaining permanent teeth to emerge properly. Read on to learn about two common permanent tooth eruption problems and their treatments.
Over-Retained Primary Tooth
As permanent teeth emerge on schedule, they typically push the primary teeth above them out of place. While every child's permanent tooth eruption timeline can vary a bit, this timeline does not typically vary by more than a year or so. If a permanent tooth does not displace a primary tooth within about a year of when the permanent tooth should typically erupt, then your child may be suffering from an over-retained primary tooth.
There are several causes of over-retained primary teeth:
Missing Permanent Tooth
The permanent tooth may simply not exist below the gum line. About 20 percent of the population has a congenitally missing tooth. This condition can be treated by simply leaving the baby tooth in place or removing the baby tooth and inserting a dental implant. If your child will need braces, then their orthodontist may choose to simply extract the baby tooth and then close the gap left behind by shifting adjacent teeth together.
Primary Tooth Fused to Jaw Bone
An over-retained primary tooth may still have an adult tooth underneath it ready to emerge. However, the primary tooth may be fused to the child's jaw bone, making it difficult for the adult tooth to push it out of place. If your child has an over-retained primary tooth fused to their jawbone, then their dentist will likely opt to extract it. Then, the adult tooth underneath it should emerge.
Enamel Hypoplasia
A very common condition that can affect a child's emerging permanent teeth is enamel hypoplasia. This condition is characterized by tooth enamel that is thinner than usual or misshapen.
While this condition can affect any or all permanent teeth, it very commonly affects a child's first permanent molars, also called six-year molars. In fact, approximately 20 percent of children ages 7 to 13 have at least one molar affected by hypoplasia.
Some teeth affected by enamel hypoplasia have white spots on them, while others have obvious pits or grooves where enamel is missing or malformed. Some even have areas that appear yellow or light brown; this occurs when the dentin under the enamel is exposed.
Enamel hypoplasia has numerous potential causes, including:
  • Primary tooth injury - If a primary tooth is injured and pushed into the permanent tooth under it when it is forming, it can cause enamel hypoplasia.
  • Genetics - Some cases of enamel hypoplasia are inherited.
  • Problems during pregnancy - Premature babies are more prone to developing this condition than full-term babies, and a vitamin D deficiency during pregnancy can also lead to a baby with enamel hypoplasia.
Vitamin deficiencies during infancy can also cause this enamel condition.
The treatments for enamel hypoplasia vary greatly depending on the teeth affected by it and the severity of the hypoplasia. If the problem is simply cosmetic and the affected teeth are in the rear of the mouth, then no treatment is often needed.
However, if the affected teeth are in the front of the mouth and/or the hypoplasia is severe, then your child's dentist may suggest placing crowns on the affected teeth or restoring them with dental resins. Alternatively, your child's dentist may recommend extraction of teeth affected with severe hypoplasia and closure of the gap left behind with braces.
Be sure to keep a close eye on your child's erupting permanent teeth to watch for problems. Notify your child's dentist of any suspected permanent tooth problems quickly to discuss how they can be managed. Contact Vicki Vida Kestler, DDS for more information or to make an appointment today.