Retained Baby Teeth: Causes and Treatment Options

Retained primary teeth?

Doctor, I would like to ask: I have not lost my primary incisors, and there are no permanent teeth below them.
They have been painful and have required ongoing treatment for a long time.
In March of this year, I had the teeth extracted, leaving a gap.
What methods are available to fill this gap? Currently, many options are not viable due to the small space.
Could this be related to a thyroid issue?

Ying, 20~29 year old female. Ask Date: 2015/09/07

Dr. Zhang Xiangyuan reply Dentistry

Dear netizen, based on your description, there is no permanent tooth present below the extracted primary incisor.
For the vacant space, it is recommended that you consult a dentist for an evaluation.
Depending on the actual conditions (size of the gap, alignment of the teeth, occlusion relationship, etc.), the dentist can assess whether it is possible to address the issue using (1) orthodontics, (2) dentures, or (3) dental fillings (for cavities).
Thyroid function may be related to the growth and eruption of teeth, but it is not significantly associated with congenital tooth agenesis.
Thank you for your inquiry.

Reply Date: 2015/09/07

More Info

Retained baby teeth, or retained primary teeth, occur when a child's primary teeth do not fall out as expected, often due to the absence of the permanent teeth beneath them. This condition can lead to various complications, including misalignment of the surrounding teeth, dental crowding, and potential issues with the child's bite. In your case, it seems that you have experienced pain and prolonged treatment related to your retained baby teeth, which ultimately led to their extraction.

The causes of retained baby teeth can vary. One common reason is the lack of permanent teeth developing in the jaw, which can be due to genetic factors or developmental issues. In some cases, the roots of the primary teeth may not resorb properly, preventing them from loosening and falling out. Additionally, conditions such as hypothyroidism or other hormonal imbalances can potentially affect dental development, although this is less common.

Once a retained baby tooth is extracted, the next steps depend on several factors, including the age of the child, the position of the surrounding teeth, and the overall dental health. Here are some treatment options to consider:
1. Space Maintainers: If the extraction of the primary tooth has left a gap, a space maintainer may be recommended. This device helps to hold the space open for the permanent tooth to erupt when it is ready. It is particularly important if the child is still young and has not yet lost other primary teeth.

2. Orthodontic Evaluation: If there are concerns about the alignment of the teeth or the potential for crowding, an orthodontic evaluation may be beneficial. An orthodontist can assess the situation and determine if braces or other orthodontic treatments are necessary to guide the permanent teeth into the correct position.

3. Monitoring: In some cases, especially if the child is still young, the dentist may recommend simply monitoring the situation. Sometimes, the permanent teeth may still develop, and the gap may close naturally over time.

4. Bone Grafting: If the space left by the extracted tooth is significant and there are concerns about the bone structure, a dentist may suggest a bone grafting procedure. This can help prepare the area for future dental implants if necessary.

5. Dental Implants: If the permanent tooth is not expected to erupt and the child is older, a dental implant may be an option. This is a more invasive procedure and typically considered when the child has reached full jaw growth, usually around late adolescence.

Regarding your concern about the thyroid issue, it is essential to discuss this with your healthcare provider. While thyroid problems can influence overall health, including dental development, a thorough evaluation by an endocrinologist may be necessary to determine if there is a direct link to your dental issues.

In conclusion, retained baby teeth can lead to various complications, and the treatment options depend on the individual case. It is crucial to work closely with a pediatric dentist or orthodontist to determine the best course of action for your child's dental health. Regular check-ups and open communication with your dental care team will help ensure that any issues are addressed promptly and effectively.

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