Paging Dr. Hive, DDS.:Child possibly missing permanent tooth?

[Element]

My ds (8.5) lost his front middle teeth (incisors- 4 on top, 4 on bottom) and his canines last year. The permanent teeth have been growing in over the past few months and I haven't really ever "examined" them. He sees a dentist every 6 to 9 months and neither I nor dh had braces so it never occurred to me to check his incoming teeth for irregularities.

 

Today, I finally really LOOKED at his incoming teeth, since it appears that his lower incisors (all 4) and canines were all mostly in. Looking at his upper teeth, though, his middle 2 incisors and his canines are mostly in, but he appears to be totally missing one of the side incisors and the other one is really small. What is going on? Would it be normal that the other 6 teeth are pretty much completely in and there is no sign of the one tooth (maxillary lateral incisor) anywhere? Why on Earth is the other one the size of a baby tooth?

 

I am absolutely freaked out right now. His next dentist appointment is scheduled for the end of May. Is this something I need to call the dentist about tomorrow? They've done x-rays on him, why wouldn't they have told me if something was wrong? If I called, would they at least be able to check his last x-rays and tell me that he has this missing tooth somewhere up there?

 

Ugh. I'm really stressed out about this right now. It never occurred to me that one of our kids might need braces or some other major dental procedure.

[Night Elf]

I would worry about an impaction and the xrays should show the position of the teeth. I would call and ask how I might know if there is a problem. How long does it take for teeth to come in?

 

FWIW, both my son and I had impacted canines. My son has braces to correct that and to also correct his underbite. His teeth were positioned very closely and his baby eye teeth never fell out. That's what happened to me too.

[Tap]

Try to not stress, I know easier said than done. I had a tooth take about a year to come in when I was little.

 

I wouldn't take him in just for that, since you already have an appointment scheduled. You may call and ask the receptionist to make sure you will have enough time to talk to the dr about it (and get current xrays if you need them).

[Cindy in FL.]

My oldest ds was missing one of his permanent teeth. In his case he had a spacer made to fit in the spot to keep his other teeth from shifting. I would call the dentist's office and run it by them. I'm not sure how long it takes for the teeth to move out of place.

 

Cindy

[Danestress]

My son is missing one. The dentist never mentioned it, but the orthodonist took a full set of xrays and caught it right away. My DS has not lost the baby tooth that this missing tooth should replace. He advised us to just have a "hands off" approach because he could well keep that baby tooth until he is 40.

[ocelotmom]

My son is missing one. The dentist never mentioned it, but the orthodonist took a full set of xrays and caught it right away. My DS has not lost the baby tooth that this missing tooth should replace. He advised us to just have a "hands off" approach because he could well keep that baby tooth until he is 40.

 

This is my family. I'm missing an adult tooth or two, and my dad had a baby tooth removed in his 40s.

[3andme]

Missing permanent teeth are not uncommon. I am missing one and I just found out my son is missing 5. I don't think there is any harm in waiting until May.

 

The position of the missing tooth would probably determine whether you need braces or not. About your son's age, they should be able to tell by looking at the x-rays if there are any tooth buds for the permanent teeth.

 

Our orthodontist said they try to keep the baby teeth intact as long as possible unless they need to be removed for other reasons. They won't necessarily fall out unless their is a permanent tooth to push it out.

Edited March 29, 2012 by 3andme

[redsquirrel]

Missing an adult tooth is not particularly uncommon. My dh is missing one, I have a friend with an extra canine tooth (we joke that she got my dh's missing tooth), my elder son is missing two adult teeth. I have no idea about my younger son, but I suspect that one baby tooth that fell out isn't getting replaced. This is not a crisis.

 

It doesn't guarantee braces either. Neither myself nor my dh needed braces but my elder son has them. His braces have nothing to do with the 2 missing adult teeth. I don't know about ds2, but I am guessing he will need them in the future.

[Element]

I would worry about an impaction and the xrays should show the position of the teeth. I would call and ask how I might know if there is a problem. How long does it take for teeth to come in?

&

Try to not stress, I know easier said than done. I had a tooth take about a year to come in when I was little.

 

I wouldn't take him in just for that, since you already have an appointment scheduled. You may call and ask the receptionist to make sure you will have enough time to talk to the dr about it (and get current xrays if you need them).

 

Thank you both for the advice. I realize this is far from a dental emergency, it just really startled me (and of course, I made the discovery about 12 seconds after the dentist's office closed for the evening.) I will definitely call tomorrow and use the suggestions from you both. I hadn't even thought about possible impaction. I looked at the gum and didn't see anything, but I wouldn't really know what to look for anyway.

 

My oldest ds was missing one of his permanent teeth. In his case he had a spacer made to fit in the spot to keep his other teeth from shifting. I would call the dentist's office and run it by them. I'm not sure how long it takes for the teeth to move out of place.

 

Cindy

 

That is exactly what I was afraid of. Right now there is barely any space in the area where the tooth should be.

 

My son is missing one. The dentist never mentioned it, but the orthodonist took a full set of xrays and caught it right away. My DS has not lost the baby tooth that this missing tooth should replace. He advised us to just have a "hands off" approach because he could well keep that baby tooth until he is 40.

&

This is my family. I'm missing an adult tooth or two, and my dad had a baby tooth removed in his 40s.

 

I'm starting to think that maybe the little tooth is actually still a baby tooth. You would think I would know which teeth my dc had lost, but I guess I honestly can't remember. There was a period of a few weeks when both kids were just losing teeth right and left.

[Element]

Missing permanent teeth are not uncommon. I am missing one and I just found out my son is missing 5. I don't think there is any harm in waiting until May.

 

The position of the missing tooth would probably determine whether you need braces or not. About your son's age, they should be able to tell by looking at the x-rays if there are any tooth buds for the permanent teeth.

 

Our orthodontist said they try to keep the baby teeth intact as long as possible unless they need to be removed for other reasons. They won't necessarily fall out unless their is a permanent tooth to push it out.

 

WOW, what a shocking discovery for you!

 

My ds's top center incisors are really big so they pushed out at least one of the baby lateral incisors (I thought they had pushed out both, but I'm now questioning whether or not this small tooth is just a baby tooth that didn't get pushed out.) I'm a little worried about having one on one side and nothing on the other.

[Element]

Missing an adult tooth is not particularly uncommon. My dh is missing one, I have a friend with an extra canine tooth (we joke that she got my dh's missing tooth), my elder son is missing two adult teeth. I have no idea about my younger son, but I suspect that one baby tooth that fell out isn't getting replaced. This is not a crisis.

 

It doesn't guarantee braces either. Neither myself nor my dh needed braces but my elder son has them. His braces have nothing to do with the 2 missing adult teeth. I don't know about ds2, but I am guessing he will need them in the future.

 

I know. You are absolutely right. This isn't a crisis. It just totally caught me by surprise. We have several medical issues in our family's history, but nothing dental. I guess I was also surprised that I look at this child for several hours a day and I never noticed an apparently missing front tooth. :confused: :001_huh:

 

Thank you for telling me that this doesn't necessarily guarantee braces because braces are just not in the budget. I don't think we have any insurance coverage for it, so that makes me feel a little better.

[redsquirrel]

To be clear, it doesn't rule braces out either. It's just that you can't assume it will mean braces are needed.

 

I know all about the braces panic. We just paid off my older son's braces. Our insurance paid a teensy bit, but not much. It was an big monthly payment. Every time I look at my kid, I see a trip to Europe in his mouth.

[ocelotmom]

I'm starting to think that maybe the little tooth is actually still a baby tooth. You would think I would know which teeth my dc had lost, but I guess I honestly can't remember. There was a period of a few weeks when both kids were just losing teeth right and left.

 

That's ok. I can't remember how many *I'm* missing! And I'm certainly unsure of exactly how many or which DS has lost.

[elise1mds]

I'm missing four (two are wisdom teeth, though). The two that I'm missing are my upper lateral incisors. My mom is missing them, too, and we suspect that my son is missing at least one of his. I had braces, but they didn't wind up doing me much good and honestly, you'd never know I'm missing teeth. My mom never had braces and you'd never know with her, either. My current dentist wants us to get DS in to see an orthodontist now to see about spacing, but I want to wait and see how a few more grow in before I consider it. :)

[Lolly]

Dd19 has very small maxillary lateral incisors. She did lose the baby teeth there. It is very, very common for those particular teeth to be small or even missing. She also has room for her wisdom teeth.:D Just wait and ask about it on the next regular cleaning. (

[shanezomom]

Our ds is missing 2 permanent teeth and the orthodontist will be shifting other teeth around to get even spacing. I am glad to hear he is not alone with this. His general dentist discovered the lack of permanent teeth up in the gums through digital xrays when our son was 8 and referred us to an orthodontist.

[sparrow]

My son had serious issues which required early orthodontic intervention. He had to get braces at age 8 to correct a crossbite that had already chipped an upper tooth. The orthodontist told us he was missing an adult incisor. In our case, it wasn't such a bad thing. Crowding was an issue, so it was one less tooth that needed to be pulled :tongue_smilie:.

 

 

To be clear, it doesn't rule braces out either. It's just that you can't assume it will mean braces are needed.

 

I know all about the braces panic. We just paid off my older son's braces. Our insurance paid a teensy bit, but not much. It was an big monthly payment. Every time I look at my kid, I see a trip to Europe in his mouth.

 

:lol: Isn't that the truth!? We have zero dental or orthodontic coverage. Everything is out of pocket. My daughter has *very* slow to erupt teeth which has been wonderful for us. Our orthodontist has been checking her mouth every 6 months for the past year and a half. She's still not ready to start treatment which works out perfectly. My son's treatment will be paid off in August! We've figured that once everything is said and done, between cleanings, fillings, extractions, and orthodontic treatment, all out of pocket, we'll have about $20,000 in our kids' mouths :svengo:.

[lorrainejmc]

I actually was hoping my ds would be missing those 2 incisors. He has a high palate and space is a big issue. I knew before he was x-rayed at the orthodontist that if the teeth weren't missing they would be impacted as there was nowhere for them to go. Thankfully, they were missing. Cosmetically, it is easily disguised with bonding material; I have one missing incisor and no space so my canine was bonded to look like an incisor and the pre molar was in such a position that it looked like a canine anyway. That is a simple option if the teeth have otherwise come down in a suitable position.

[Element]

Well, I talked to the receptionist today over the phone and she wasn't very helpful. (This is an income-based community dental clinic so they are always really busy and never very helpful.) She just said "It will be fine, they'll look at it when he comes in in May." I asked her again if she could look at his most recent x-rays to just see if he had tooth buds there, to which she replied, "He's eight. They're not worried about it. They'll do an x-ray of his whole mouth when he comes in in May if you're still worried about it then." :confused: So that was frustrating. I just wanted to know if he had tooth buds, but now I'm wondering if they have even been x-raying him at all.

 

I know. It's not that big of a deal. I just wanted to update here. Hopefully I'll know more in a couple of months.

 

Thank you everyone for the helpful advice. I needed someone to talk to about this yesterday, so I really appreciate being able to come here for things like this.

[EKS]

It's fairly common for the lateral incisors to be missing. I know this because my son lost his and the new ones didn't come in for two years. After about a year, the dentist took an x-ray and found them, but my son had to get braces (at age 8) to make it so there was enough room for them to come in.

 

I know a kid who has missing lateral incisors. He has a special retainer with fake ones at the moment but I'm not sure what the long term plan is.

[HLDoll]

My son lost his incisors in Dec 2010. At his July 2011 check-up, I asked for X-rays because they hadn't come in and my brother was missing one of his permanent teeth. They said the teeth were there and not to worry. It's now been 15+ months and one has finally started to come down, although there is still no outward sign of the other. He's had a gappy smile forever!

[Desert Rat]

I'm missing 3 adult teeth. I did need years of braces and had a small mouth so I ended up getting another 4 permanent teeth pulled. I needed braces not for gaps from missing teeth but for the overcrowding and bite problems. It's not uncommon to be missing teeth and you may not need braces if the other teeth shift to compensate.

[LucyStoner]

Apparently if you have impacted or missing teeth,it is VERY common to have 1 or more irregularly sized teeth. At least this is what both my oral surgeon and an ortho I consulted with said.

 

I had very crowded teeth, top and bottom + 1 top bicuspid (just back from the canines) completely impacted laying directly next to my sinuses and another top bicuspid tripod-ing with my other teeth. It had erupted fully behind the canine and the other bicuspid on that side but I could not see it without a mirror or two. Talk about some fun flossing. I also, like your son, have a top incisor that is no bigger than a baby tooth.

 

In a young kid they may be able to re-position and pull the impacted tooth into place. Several of my friends had this done. We did not have any $$ for orthodontia when I was a kid so I tap away this message, coming up on 32, I have a full mouth of metal. My braces will be off in a little over a year. :D For the small tooth, I have chosen to have the ortho leave space for that tooth to be capped to make it the same size as it's tooth on the other side. If it was not right up front, I would not worry about it but it is and I work in a smile oriented/social field. Nice teeth help.

 

It sounds like your son just got the short straw on teeth. I would make sure he is flossing well to prevent decay (common in people with crowded teeth) and I would consult a few orthodontists and get an idea of if/when/how/how much $ etc. Who knows, maybe it will not be necessary. That said, if it is not $$ possibility but is recommended, remember he can always just get them when he is older if it bothers him. I lived just fine without the braces it it was ultimately only because we had some extra $ and because of the crowding and appearance for work thing that we sprung for it.

Edited March 29, 2012 by kijipt

[LisaKinVA]

I haven't read all of the replies...but I'm missing 9 permanent teeth.

 

The one thing that strikes me as "odd" for a "missing tooth" is that the baby tooth doesn't normally fall out on its own. In the case of my missing incisors, my canines pushed my incisors out, but I retained my "baby" canines, because there was nothing above them to grind the root away.

 

If the baby tooth did fall out, and nothing has taken it's place, I would place my money on slow-regrowth, or impacted teeth -- not missing teeth. My oldest son had one canine that took forever to grow in (well over a year). It's finally there, although his other teeth grew in just fine. This son is missing one adult molar, that is the only "baby tooth" left in his mouth.

[Sparkle]

To be clear, it doesn't rule braces out either. It's just that you can't assume it will mean braces are needed.

 

I know all about the braces panic. We just paid off my older son's braces. Our insurance paid a teensy bit, but not much. It was an big monthly payment. Every time I look at my kid, I see a trip to Europe in his mouth.

 

:lol: I feel the pain as well. My dd's braces cost the same amount as my dh's car did. I'm like, "We could have bought another car with those braces!"

 

OP, my dh has a missing upper canine tooth, but you wouldn't ever really notice it unless you looked super closely.

 

DD on the other hand, had several teeth which were not descending because some other ones were blocking them, so she needs full-on orthodontic treatment. We didn't find out about this or start with braces till she was 11 though.

 

Also, one other thought, my oldest ds lost his upper incisor baby tooth very early because he fell and hit it and it had to be extracted. We kept waiting (and waiting and waiting) for the adult tooth to come in. It turned out that he had an EXTRA tooth up in his gum that was stuck and not coming through, and preventing the adult tooth from coming through. It had to be extracted surgically (and man, it was HUGE), and finally, finally the adult tooth came in. He looks perfect now.

[Mommyfaithe]

My son is missing one. The dentist never mentioned it, but the orthodonist took a full set of xrays and caught it right away. My DS has not lost the baby tooth that this missing tooth should replace. He advised us to just have a "hands off" approach because he could well keep that baby tooth until he is 40.

 

Yup...dd 25, has a baby tooth still....and my friends Mom still has one at almost 70!!! It never fell out, and so she just left well enough alone.

[Element]

The one thing that strikes me as "odd" for a "missing tooth" is that the baby tooth doesn't normally fall out on its own.

 

It doesn't really surprise me because his central incisors are huge. There is a slight gap between the 2 centrals, but no gap (between the central incisor and canine) where the lateral incisor should go. I think the big front tooth pushed out the central and lateral incisor on that side.

 

My dh was born without radii and almost non-existent ulnae so a missing tooth or two isn't so bad I suppose. I am glad to hear that it's a fairly common occurrence.