Dealing with Retained Baby Teeth: Concerns and Solutions for Adults

The primary teeth have not yet fallen out?

Hello Doctor: I am 25 years old, and the tooth next to my front tooth is still a primary tooth.
I have visited a dentist, and the doctor said that my primary tooth has become fixed, and the permanent tooth cannot push it down, so it has grown up to the gum line and is now protruding.
I would like to ask the doctor: 1.
The permanent tooth has grown up to the gum line, and initially, it was only slightly visible, but over time, it seems to be getting larger.
Is it because it is protruding from the gum line without being blocked by the lower teeth that it will continue to grow slowly? 2.
I have asked the doctor whether the tooth growing on the gum line needs to be addressed, and the doctor replied that if it does not cause any issues, it can be left alone.
However, recently, sometimes the gum near the permanent tooth on the gum line has been painful.
Could it be pressing against other teeth? 3.
I have considered having a tooth extraction, but I am unsure whether to extract the primary tooth and orthodontically manage the permanent tooth or to directly surgically remove the permanent tooth.
I would appreciate any valuable advice from the doctor! Thank you.

LING, 20~29 year old female. Ask Date: 2016/04/18

Dr. Zeng Guanghui reply Dentistry

1.
In order for primary teeth to be replaced, the permanent tooth bud must continuously grow towards the occlusal surface, pushing against the roots of the primary teeth, causing root resorption and loosening of the primary teeth, which will then fall out, allowing the permanent teeth to emerge.
However, if the eruption path of the permanent teeth is abnormal and grows towards the buccal or lingual side, the primary teeth may not undergo resorption, resulting in the permanent teeth eventually erupting through the buccal or lingual gingiva.
2.
If the permanent teeth erupt in a position that makes oral hygiene difficult and leads to gingival inflammation, it is advisable to seek treatment.
Taking X-rays can help determine if there is any pressure on adjacent teeth.
3.
If the remaining primary teeth are of a size and shape that can withstand occlusal forces, and if there is a desire to avoid lengthy orthodontic treatment, one might consider extracting the permanent teeth while retaining the primary teeth.
Otherwise, it is still recommended to extract the primary teeth and proceed with orthodontic treatment for the permanent teeth.

Reply Date: 2016/04/18

More Info

Dealing with retained baby teeth, especially in young adults, can be a complex issue that requires careful consideration and professional guidance. In your case, it appears that you have a retained primary tooth (baby tooth) that is not being replaced by the permanent tooth (adult tooth) as expected. This situation can lead to various dental complications, and it's essential to address your concerns systematically.

1. Growth of the Permanent Tooth: The fact that your permanent tooth is partially erupted and appears to be growing larger over time is concerning. When a permanent tooth is not properly aligned or is obstructed by a retained baby tooth, it can lead to an abnormal eruption pattern. The lack of opposing teeth (in your case, the lower teeth) can sometimes allow the tooth to continue to erupt further into the gum tissue, which may lead to discomfort or pain. This situation can also cause the tooth to become impacted, meaning it is unable to fully emerge due to obstruction. Regular dental check-ups are crucial to monitor this situation and determine if intervention is necessary.

2. Pain and Discomfort: The pain you are experiencing around the gum area of the erupted permanent tooth could indicate that the tooth is indeed putting pressure on adjacent teeth or that there is inflammation in the gum tissue. This could lead to periodontal issues if not addressed. It's essential to communicate this discomfort to your dentist, as it may require further evaluation, possibly including X-rays to assess the positioning of the teeth and roots.

3. Treatment Options: When it comes to treatment, there are generally a few options to consider:
- Extraction of the Retained Baby Tooth: If the primary tooth is not serving a functional purpose and is causing issues, your dentist may recommend extraction. This can allow the permanent tooth to move into its proper position.

- Orthodontic Evaluation: After the extraction of the baby tooth, an orthodontic evaluation may be necessary to determine if braces or other orthodontic treatments are needed to align the permanent tooth properly. This is especially important if the permanent tooth is not in the correct position.

- Surgical Options: In some cases, if the permanent tooth is severely impacted or if there are complications, surgical intervention may be required. This could involve removing the impacted tooth or repositioning it.

In conclusion, it is crucial to maintain open communication with your dental care provider about your symptoms and concerns. Regular follow-ups will help monitor the situation, and your dentist can provide tailored recommendations based on your specific dental anatomy and health. If you are experiencing pain or discomfort, do not hesitate to seek immediate dental care. Early intervention can prevent more severe complications down the line and ensure that your dental health is maintained.

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