Adult with Baby Teeth

As a parent, we all wait for our children to achieve different milestones, one of which is losing their first teeth.

As a child, we love to lose teeth and wait for the tooth fairy to visit us. But for some of us, this may be delayed.

In some cases, we can see primary teeth in adults too. Usually, everyone loses their primary teeth by the age of 12.

But in some cases, we can see adults with primary teeth, most commonly the second primary molars or primary canines.

Retained primary teeth do not usually cause any problem, but some people may have an aesthetic concern. Let find out more about retained primary teeth and its related interests.

What are retained primary teeth?

A primary tooth is considered over retained when the eruption of the corresponding permanent tooth is delayed for more than a year from the expected date.

The most common cause for an over-retrained primary tooth is the absence of an adult tooth to replace it.

Cause for retained primary teeth.

There are several reasons for a primary tooth to be over- retained and the delayed eruption of permanent teeth. The causes are listed as follows:

  • Lack of corresponding permanent tooth to replace the primary tooth.
  • Tooth ankylosis- the primary tooth is fused to the jaw bone.
  • Traumatic injuries and infection.
  • Obstruction in the eruption pathway.
  • Conditions resulting in retained primary teeth:
  • Hyperdontia – These are the extra primary teeth, and there is not enough room for permanent teeth to erupt.
  • Hypodontia – 1 to 5 permanent teeth are missing.
  • Oligodontia – 6 or more permanent teeth are missing.
  • Anodontia – all of the permanent teeth are missing.
  • Genetics – you are most likely to have a retained milk tooth if either of your parents had it too. (1)
  • Condition affecting tooth development like ectodermal dysplasia and endocrine disorder.

Problems with retained primary teeth.

Adults with retained primary teeth usually do not notice them, and their only concern can be aesthetics.

Retained primary teeth can function as effectively as permanent teeth. But adults with retained primary teeth may feel odd as primary teeth are shorter in size than permanent teeth.

A poorly aligned milk tooth can affect the position of other teeth in the mouth. A crooked primary tooth can make it difficult to clean & you can develop cavities & tooth decay.

In some severe cases, retained primary teeth can cause severe infection and speech problem. It is believed that retention of the incisors & first molars requires more treatment.

Treatment for the retained primary teeth.

The treatment option for the over-retained primary teeth depends on the condition of the primary tooth and the surrounding structure.

It is essential that a dentist evaluate the child along with an orthodontist to develop an appropriate plan.

A dentist conducts a thorough oral examination and takes several x-rays, to decide what to do with your tooth.

There is a chance that your milk tooth can shed, in adulthood, without a permanent tooth to replace it.

This creates a gap which causes problems with the function of your bite and alignment of your surrounding teeth.

These are the treatment options available for over-retained primary teeth:

  • Orthodontics & surgery

If the primary tooth is structurally and aesthetically acceptable, the orthodontist can modify the tooth by adding a molded can to the tip of the primary tooth. This gives the appearance of a permanent tooth while maintaining the integrity of the tooth’s base.

  • Extraction

You may require extracting the retained primary tooth in such case:

  • When crowding is severe enough, the primary tooth needs to be removed and straighten the remaining permanent teeth.
  • If the primary tooth has significant weakness, such as root resorption, tooth decay.(2)

In case of extraction of the retained primary tooth, replacement is necessary. Usually, implants are the preferred replacement method.

But it is not recommended in children as the skeletal structure is still forming. Partial dentures are the popular solution for a replacement if there are a large number of missing teeth.

  • Dental bonding

This is the most common aesthetic solution to treat the retained tooth. The dentist uses a composite resin to build-up the tooth.

So, it is the appropriate size & shape. The material is permanently bonded to the tooth, to make the tooth look natural and function normally.

Take away message

An over-retained primary tooth can be retained forever unless it causes distress to the other teeth and mouth.

The main concern for a person with a retained primary tooth is aesthetics, but it can have more severe effects too.

There are many treatment options available, should you opt to get your retained tooth corrected.

A dentist & orthodontist will work together to evaluate the retained primary tooth and decide the appropriate treatment plan for you, accordingly to your needs and requirements.