My child has a missing permanent tooth-what should I do?

If your child has a missing permanent tooth, what needs to be done depends on the specifics of that situation.  This needs to be confirmed with a periapical xray, or a panoramic xray (panorex-see previous blog about monitoring your child’ s  dental development) .  The worse case that  I have seen was a young man who only had his 2 front teeth and his 6 year (1st) molars on his upper jaw.  He was also missing his 2 lower central incisors (front teeth).  For his situation, we did orthodontics and an upper partial denture and a lower partial denture to replace the missing teeth.

Most situations are not this severe.  I have a son and daughter that are missing the permanent premolar, or bicuspid that is supposed to replace their 2nd baby molar.  The best thing to do in this situatiion is to take care of that baby tooth and keep it as long as possible.  I have patients that have been able to keep these retained baby teeth until they were almost 50 years old and then we placed an implant with a crown, or a permanent bridge when the baby tooth was extracted.

If you have a panoramic x-ray (panorex) taken on your child and they have any missing teeth, ask your dentist what the treatment options are.  Then choose the one that y0u feel will be best for your child.  Thanks again for the questions.  I really want to help in any way I can and my advice is free.


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My son is well past 8 (will be 9 in January). When he was about 4 or 5, he and his older cousin were playing “wrestling” at his aunts house. I recieved an emergency call at work that there was an accident. When I arrived at the hosipital, I found out that he fell into the corner of the wooden arm on her couch, mouth first. The front tooth was jammed into his gums as if half of his baby tooth was missing. The doctor said it would be fine so long as it fell it out. I scheduled a dentist appointment, and his tooth did fall out well before the appointment date. The dentist said that he could see no damage, and he should be fine. Well, he has been missing his front top tooth for about 3-4 years now. We went to the dentist last year and I was told to give it some time. They did xrays, and the nurse informed me that they could not see a permanent tooth and it is not likely that a child at his age can recieve a cap. What am I supposed to do? His other front tooth had already fallen out and grew back in, along with a few other permanent teeth. Now he is complaining. Any assistance would be greatly appreciated. Thanks.

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My son is well past 8 (will be 9 in January). When he was about 4 or 5, he and his older cousin were playing “wrestling” at his aunts house. I recieved an emergency call at work that there was an accident. When I arrived at the hosipital, I found out that he fell into the corner of the wooden arm on her couch, mouth first. The front tooth was jammed into his gums as if half of his baby tooth was missing. The doctor said it would be fine so long as it fell it out. I scheduled a dentist appointment, and his tooth did fall out well before the appointment date. The dentist said that he could see no damage, and he should be fine. Well, he has been missing his front top tooth for about 3-4 years now. We went to the dentist last year and I was told to give it some time. They did xrays, and the nurse informed me that they could not see a permanent tooth and it is not likely that a child at his age can recieve a cap. What am I supposed to do? His other front tooth had already fallen out and grew back in, along with a few other permanent teeth. Now he is complaining. Any assistance would be greatly appreciated. Thanks.

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