Concerns About Permanent Tooth Growth After Baby Tooth Injury

After a primary tooth is fractured, the permanent tooth has not erupted?

Hello Dr.
Tseng, my puppy is seven years old this year.
Last autumn, while riding a bicycle, he had an accident that caused one of his upper incisors (primary tooth) to break (tooth 2.1) when it became loose.
Later, the other incisor (1.1) also gradually fell out, and the permanent teeth have come in.
However, the injured permanent tooth (2.1) has not erupted yet, and now the adjacent primary tooth (2.2) has also fallen out and is starting to grow in.
I am very concerned.
Could you please advise if there is an issue with the injured tooth and what treatment options might be available? Thank you for your response, and I wish you peace and good health.

An, 30~39 year old female. Ask Date: 2016/04/30

Dr. Zeng Guanghui reply Dentistry

In a car accident, two upper primary incisors were broken, with one primary incisor falling out.
There is concern about the gum tissue growing in, but the other broken primary incisor has not yet developed its permanent successor.
The adjacent primary tooth is also loose and has begun to erupt its permanent tooth.
It is possible that the unerupted permanent incisor may have sustained damage to its dental follicle, leading to eruption issues.
It is recommended to consult a dentist for an X-ray examination to conduct further diagnosis and treatment.

Reply Date: 2016/04/30

More Info

When it comes to concerns about the growth of permanent teeth following an injury to baby teeth, it is essential to understand the relationship between primary (baby) teeth and their permanent successors. The situation you described involves a child who suffered an injury that resulted in the loss of a primary tooth and the delayed eruption of the corresponding permanent tooth. This can be a source of anxiety for parents, and it is important to address these concerns with accurate information.

First, it is crucial to recognize that primary teeth play a significant role in the development of the dental arch and the proper alignment of permanent teeth. They serve as placeholders for the permanent teeth that will eventually erupt. When a primary tooth is lost prematurely due to trauma, it can potentially affect the eruption pattern of the permanent tooth. In your case, the injury to the primary tooth (2.1) may have impacted the underlying permanent tooth, causing it to be delayed in its eruption.

The fact that the adjacent primary tooth (2.2) has also fallen out and is now allowing for the eruption of the permanent tooth is a positive sign. However, the absence of the permanent tooth (2.1) raises concerns about whether the injury has caused any damage to the tooth bud or the surrounding structures. If the tooth bud was affected, it could lead to complications such as delayed eruption or even failure of the permanent tooth to develop.

In terms of treatment options, it is advisable to consult with a pediatric dentist who can perform a thorough examination and possibly take X-rays to assess the condition of the tooth bud for the permanent tooth (2.1). This imaging will help determine if there is any damage that could hinder its development. If the tooth bud is intact, it may simply be a matter of time before the permanent tooth erupts. However, if there is damage, the dentist may discuss potential interventions, such as monitoring the situation closely or considering space maintainers if necessary.

Space maintainers are dental devices used to hold the space for the permanent teeth when a primary tooth is lost prematurely. They can prevent adjacent teeth from drifting into the space, which could lead to misalignment of the permanent teeth. The decision to use a space maintainer will depend on the specific circumstances of your child's dental development and the dentist's recommendations.

It is also important to monitor your child's dental health closely during this period. Regular dental check-ups will ensure that any issues are identified early and addressed promptly. If you notice any signs of discomfort, swelling, or changes in the alignment of the teeth, it is essential to seek dental care as soon as possible.

In summary, while the injury to the primary tooth can raise concerns about the growth of the permanent tooth, a thorough evaluation by a pediatric dentist will provide clarity on the situation. They can assess the health of the tooth bud and recommend appropriate treatment options if necessary. Regular monitoring and dental visits will be key to ensuring your child's dental health during this critical period of development.

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