What to do if your child is missing his or her adult teeth

Dr. Holly Austgen, DDS of Southeast Family Dental in Indianapolis, Indiana discusses reasons a child may be missing his or her and what treatment options are available.

If you can not see the embedded video above please use the following link: What to do if your child is missing his or her adult teeth

Transcript

Hi! I’m Dr. Holly Austgen with Southeast Family Dental and today we are going to talk about children that are missing their adult teeth. As children start losing their teeth, many parents worry about how and when the adult teeth will come in. But what if they haven’t come in or you have been told they won’t? Now what?

There are many reasons why children will not get their adult teeth. First, it’s possible that the child lost their baby tooth too early and the adult tooth is not ready to come in. It could also be that the adult tooth does not have enough room to come in between the teeth that are already there, or for that, or one other reason, the adult tooth simply did not form.

Treating this problem in children will vary based on why the adult tooth has not come in. For instance, the adult tooth is just not ready to come in, the dentist may want to place an that will hold the space until the tooth starts coming through the gums. This treatment prevents the issue of not having enough room for the adult tooth to come in. When the adult tooth does not have room to come in, it becomes more involved and an will need to be consulted to move the other teeth in order to make room and in some cases an appliance to pull the tooth through the gums.

And lastly, when an adult tooth has failed to form, there are a few ways to address this. Often, if it’s one or two teeth, a patient can maintain the baby tooth for as long as possible. Very often, if well taken care of, someone can keep their baby tooth long into adulthood and sometimes for life. However, if the baby tooth is lost or needs to be removed, other options can also be discussed.

If the missing adult teeth are more than one or two, this becomes an issue with function and maintenance of the teeth that are there. First, though, if a child is missing multiple adult teeth, a consult with the child’s is recommended to rule out conditions that may affect the entire body.

A child missing their adult teeth can have a broad range of very straight-forward treatments to other conditions that require more involvement with your dentist. It is important that a child be seen on a regular basis to keep an eye on their adult teeth and how they’re coming in.

If you have any questions, please give us a call at 317-359-8000. This is Dr. Austgen with Southeast Family Dental, and remember, we can make you smile!

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50 Responses to What to do if your child is missing his or her adult teeth

  1. Jessica Booth says:

    Hello,

    I have a friend who never got any permanent teeth. She is worried about the enamel on her teeth, and I have been looking for any advice on how to take care of baby teeth when those ARE your only teeth for life. I can’t find anything! Is there anything special you would recommend?

    Sincerely,
    Jess

  2. Southeast Family Dental says:

    Wow! Missing all of your adult teeth is extremely rare. The key to keeping those baby teeth as long as possible is prevention, prevention, prevention. The most important thing for your friend to do is to keep his/her teeth as clean as possible and to maintain routine dental care. It would also benefit him/her to stay away from consuming foods or drinks with high sugar and acid contents, such as soda, fruit juice, sports drinks, candies, etc. Baby teeth do not have the thick shell of enamel that adult teeth do and they are particularly prone to acid erosion and decay. The use of fluoride tooth pastes and rinses would be strongly recommended to help strengthen the enamel and prevent the spread of decay. His/her dentist or physician can write for prescription strength fluoride treatments such as tooth paste or gel that can be worn in custom fabricated tray overnight. A custom fabricated mouth guard may also help with the wear the occurs with daily functioning and grinding on those baby teeth. I you find this information helpful – thank you for you comment.

  3. Kim says:

    Hello,

    My 15 year old son still has one baby tooth, and is getting his braces off today. Both his dentist and orthodontist recommend having it removed, but I’m not clear as to why? I will try to find out today, but in the meantime, what are your thoughts as to why a baby tooth would need to be removed?

    Kim

    • Southeast Family Dental says:

      Without being able to see, most of the time a dentist will recommend having a baby tooth removed to give the adult tooth more room to come in. I hope you found out more at his appointment!

  4. shae says:

    hi, my name is shae and my 13 year old daughter got her last 2 baby teeth out over a year ago and theyhave hardly came back in yet we see them but they just wont come any more how can we get them to come down?
    ps. we dont want any aplyances she has braces so nothing like that

    • Southeast Family Dental says:

      There are a couple reasons they may not have come through yet. One being that It could be that the space for them to come in is too small and without opening the space, the teeth will not come through. Unfortunately, in these cases, without braces or other orthodontic appliances, there are no good options for having the teeth come in faster. Another is that the root of the tooth is not formed enough to push the tooth through. The problem with this, is that normally a tooth will not even break the surface until there is enough root formed, but there are always the exception to the rule! I would have your dentist take an x-ray to see the exact position of the teeth to give you a better idea of if/when they will come through.

  5. Lee says:

    My daughter is missing at least four of her adult teeth. I believe they are noted at 28, 29, 21 and 20. Her orthodontist said they could install pins to pull her adult teeth from the back forward. I can’t find anything on this procedure. Can you advise anything?

    • Southeast Family Dental says:

      Missing those 4 adult teeth is a lot! And moving the others forward is an option, but with the amount they need to be moved, it seems like quite a bit. From what you have said, it sounds like they want to place orthodontics (braces) on the teeth to help move them forward. The problem with this is when you move all the lower teeth forward, the upper teeth may not have something to chew against. Without being able to see, I would recommend talking about space maintainer options until something more permanent can be done. What you don’t want to do is have the space close up so much that it limits your options. There are a few different ways to hold the space so I would discuss those options with your dentist (flipper vs. lingual arch). These will give you the time and physical space to explore other options for closing the spaces.

  6. Jacki says:

    Our son is 8 and the dentist said at his last appointment that he is missing 17 adult teeth total (this includes his 4 wisdom teeth). We are extremely alarmed, and concerned how we will approach a treatment from year to year. He told us this is extremely uncommon, but our son does not have any other traits that would associate this with a disease. He said it was genetic. Are there things that can be done along the way to help him so that cosmetically his teeth will look as normal as possible. I have concerns of his self-esteem as he grows?

    • Southeast Family Dental says:

      Missing teeth, especially in children, is a really challenging and touchy subject for both the patient and the parent! It is hard to hear that your son will have spaces in his smile. I would recommend making sure to take very good care of the baby teeth to retain them as long as possible. This will help to hold some spaces and keep a natural smile. Some patients can maintain baby teeth for a long time! 13 is a lot, so you will definitely be replacing some, but making sure to keep what he has now is very important!

      Then, I would make sure to plan for the future. Knowing that you will be putting a lot of time and money investments into replacing these teeth is important! There are a few options to hold spaces and that is the most important thing at this point. In a case where there are many missing teeth,a flipper (retainer with teeth attached) is a good option. However, you have to make sure your son is ready for it because it comes in and out (can be lost) and must be cleaned just like natural teeth.

  7. Ahmad says:

    Hello,

    My daughter had 5 of her baby tooth removed last year by a dentist at a hospital in the Netherlands, the reason was that her teeth needed many fillings and the dentist said it would be better to remove them as she will get her permenant teeth soon rather than doing the fillings.A few months after removing them the dentist shocked us with the news that our daughter who is 8.5 years now will NEVER have adult teeth in their place.
    I am no dentist but this sounds strange to me, did the dentist do the right thing, shouldn’t she have checked the situation of adult teeth development under the gum before removing the baby teeth, what are our options?

    All the best,
    Ahmad

    • Southeast Family Dental says:

      Ahmad,
      I am sorry to hear about your daughter’s dental problems! In our office, on routine exams, we will take xrays to ensure adult teeth are forming and going to replace the baby teeth. If a child is missing their adult teeth, It is possible to keep baby teeth as long as they are healthy and can support the bite. Without seeing your daughter’s teeth before they were removed, it could be possible they would have needed to come out because they wouldn’t have lasted long-term.

      Now, though, what do you do? I would talk to a dentist or orthodontist about maintaining the spaces she is now going to have either with a space maintainer or a flipper (a removable retainer with teeth on it). This will give you the most options for replacing the teeth down the road and will minimize problems while she continues to grow and have her adult teeth come in! Good luck!

      Dr. G

  8. jade says:

    Hi there.

    I got my tooth pulled when i was 13 as a tooth right underneath was ready to come through (canine) I am now nearly 18 and my tooth only began coming through this year and only a miniscule amount, how can I fix this?

    • Southeast Family Dental says:

      Without being able to see the tooth, I cannot tell you exactly what to do. But I would talk to your dentist about seeing an orthodontist. The tooth may not be through because there is no space for it to come through. Braces could help give the space. Another issue may be that it is not going to come through on its own and it may need to be pulled through the gums. Again, an orthodontist can help with this process. Lastly, it could be that the tooth itself is all the way through, but the gums have come down with it. In this case, removing some gum tissue can uncover the tooth. I apologize for the multiple options, but again, without being able to see it I can’t give a definite answer. Good luck!

  9. Angela Cole says:

    My son is 9 he had I believe a 2nd molar pulled today. Yesterday the dentist said he would not need a spacer cause the permanent tooth was right there now today she says he does need a spacer. Is it necessary to have the spacer?

    • Southeast Family Dental says:

      If your son had his second baby molar taken out I would consider having a spacer placed. It may have seemed like the tooth was right there, but sometimes on further investigation a tooth may look like they are “right there” on the xray, but they can come in slowly. There are always exceptions, but in general, his permanent tooth does not come through until the ages of 11-13. That gives plenty of time for the space to be lost. If it were me, to avoid problems in the future, I would definitely have a spacer placed. Thank you for your question!

  10. Ngaia Richardson says:

    Hi! My daughter is almost 8 and has not lost any teeth. She has had an xray at the dentist and it shows that NO new teeth are forming underneath. They have referred us to a more senior dentist, but the appointment is a long time away. Should we be worried? What options do we have? Will she ever get any adult teeth?

    • Southeast Family Dental says:

      Thank you for your questions! This is a tough situation because there is a reason baby teeth come out – they are not strong enough to withstand the forces of biting that we place as we grow. Unfortunately, a lot of the first adult teeth to form have completed the crown (part of tooth that comes through the gum) formation at 4-5 years of age. This would show up on the xray. It is very rare to not form any permanent teeth. What is more likely is that she will be missing some of the permanent teeth, but will still get others. My main concern at this point, would be to find out if there is a reason she did not form the teeth? Is there a history of missing permanent teeth in your family? Does she have an underlying condition that prevented them from forming? These are questions that a dentist and your doctor would need to help answer. It also could be she has a condition that has slowed the formation. Maybe she is going to get them at a later time. At this point, there is not a lot you can do besides know, and plan, for your daughter to need a lot of dental work in the future. Look over all of your options (there are too many for me to break down without seeing your daughter) and make sure she feels comfortable in the dental chair. Good luck and let us know if we can help!

  11. Kayla says:

    Hello, I am a 17 year old girl and still have two baby teeth. Recently I went to the dentist, and they told me that I only have a permanent on one side. It just started growing in in the past year, and it is at an angle. They referred me to the orthodontist who says I should get it pulled and get braces. I am happy with the appearance of my teeth, and $5,000 seems like a lot to take care of one tooth. Is this common? If I get it pulled and do not get braces is there the possibility that it may never grow in and all my teeth would shift? What kind of dentist should I go to for this?

    • Southeast Family Dental says:

      Retaining baby teeth is fairly common, depending on where your baby teeth are. And every situation is different! Some patients can keep baby teeth well into adulthood and may keep them their entire lives, while others lose them early. The issue with not having the tooth taken out, is that it may be lost eventually anyway and the permanent tooth could then, like you said, be at such an angle that it will not come through. This would mean your teeth could shift and with a permanent tooth in the bone, may limit your options as far as replacing the tooth. The orthodontist may be planning on placing a device that would pull the permanent tooth through the gums. You are with the right people to answer your questions, though! The general dentist may take the baby tooth out, but the orthodontist is going to help maintain the space if the permanent tooth doesn’t come in or, in my thoughts, will help guide the permanent tooth in. Good luck!

  12. Julie says:

    Hi, My 6 yr old twins went to the dentist today. He told us that my son is missing 9 adult teeth and my daughter is missing 7 adult teeth. My husband does have one missing tooth in this mouth. We are fairly confident that this is genetic; however, is there any chance some of these are just to far up to show on a x-ray yet? I am truly concerned. Help pleaes!

    • Southeast Family Dental says:

      While they have not completed formation, most permanent teeth begin calcifying (and would show up on x-rays) between 3 months and 2.5 years of age. It is possible, though unlikely, that all of the teeth your son and daughter are missing would have not started forming at their age. Unfortunately, there is not a lot you can do other than plan for dental work in the future. Good luck!

  13. Claire says:

    I am 55 and still have one baby tooth. I grew up missing 6 permanent molars. I had no wisdom teeth either. Over the years I have had three bridges put in. One bridge has been replaced, and another needs to be replaced. If I could do it all over again, I would have had my missing teeth replaced with a peg tooth ( not sure what the correct name for it is). So now with my 6 missing teeth, I have six caps on my “good” teeth along with 2 root canals. This is an inherited trait from my dad. My daughter has missing teeth and so does my grandson. The cost for bridges was a lot even with insurance. The peg teeth were not covered by my insurance. Replacing the bridges is costly. I was considering getting dentures now.

  14. brandy says:

    Hi,
    My son is one and just started getting his primary teeth. I noticed today that it appears his canines are coming thru in the lateral insicor posotion and there are no spaces nor signs of the insicors coming in. Might be a silly question but if he doesn’t have primary lateral insicors,does that mean he wont have permanent insicors? I work in the dental field but we only see adults and we have treated patients that are congenitally missing their insicors..just wondering if this will be my sons issue. Thanks for any info u can provide me with.

    • Southeast Family Dental says:

      Just because a child is missing their primary lateral incisors, doesn’t mean they are missing their permanent! Just like if someone has their primary, it doesn’t mean they have their permanent.

      I would just keep an eye on the eruption. Some primary teeth are a lot more pointy than their permanent counterpart. Your son’s jaw is also a lot smaller now than it will be soon so he may have his primary lateral incisors after all!

  15. Liza says:

    Hi, my 6 yr old son had his two upper front teeth pulled about 4 months ago and they still haven’t grown back. He’s gums look a little bulgy or swollen but there’s no discomfort or pain. How long is too long? And is there a possibility that they may never grow back? What are some of the intervention procedures if any?
    Thanks

    • Southeast Family Dental says:

      Being that he had his two baby teeth extracted, 4 months isn’t too long. Sometimes the adult teeth can take awhile to come in even if they lost the baby teeth on their own. If the gum is swollen, it probably means they are on their way in. I wouldn’t worry about them not being there. They are probably just taking their time!

  16. Sandra says:

    Hi, my 15 year old is missing all 8 of his premolars! He inherited this from me, I still have 1, but not 8. He was playing basketball and one of them is now very loose. Was wondering, what do you think would be an adequate treatment? Thank you and greatly appreciate your response.

  17. Kathryn says:

    Hi
    My son is 6 and lost his 2 top front teeth 14 months ago and there is no sign of his adult teeth. He lost 4 bottom ones around tithe same time and his adult teeth have grown fine. Is this normal?
    Thanks
    Kathryn

  18. Carol says:

    My 11 year old daughter has baby teeth (marked in a diagram labeled as teeth T and K) where an x-ray shows that there are no permanent teeth that have formed to take their place. She is seeing an orthodontist and is ready to have braces put on for a slight overbite. The orthodontist said we have two choices. We can choose to try to keep the baby teeth which have small but healthy looking roots for as long as possible. Or we can have the two teeth pulled and the bottom teeth manipulated to fill in the space. This would mean artifical implants later in life (timeline unknown.) The orthodontist said this may mean the shape of her lower jaw would change a bit and might change her appearance. I do not feel that we, as her parents, are educated enough about this to make this decision. Is there any way that you could give us the recommendation that you would make in this situation?

  19. Kim says:

    Hi,
    My 11 year old daughter is missing 6 permanent teeth. 2 upper lateral incisors and upper 2 and lower 2 premolars. She us in braces now to open up space in front for implants of the 2 lateral incisors. Orthodontists all suggest pulling her 4 baby premolars and close those gaps now, but I wonder if I should just leave them there for as long as they will last. What would you suggest? I would have closed all her gaps to eliminate the need to wear a flipper with fake teeth on it but because 4 teeth are missing on the top we thought it best to go this route. My 13 year old son is also missing his top lateral incisors and because he refused to wear a flipper with fake teeth for the next 6 years we decided to just close the space and shape canines to look like incisors as best we can. Easier to do since he was only missing 2 teeth. Now my 16 month old only has 1 upper lateral incisor on top. Sigh* looks like I may be going thru all this again in 10 years. So my question is …..do I pull my daughters baby premolars and just close space now or leave them I until they fall out and leave it up to her as an adult to fix?
    I appreciate any advice.
    Thanks

  20. erica says:

    My 5 year old had his two front teeth removed at 10 mths. The adult teeth have not appeared. He lost a baby tooth last night. I am worried about his front teeth. When should I expect them, approximately?

  21. pam says:

    I have a little girl who just turned 6 and all of her bottom teeth are gone and have been since she was 5 there is no sign of her permanent teeth growing back. It’s like she doesn’t have any roots. What could this b. And she has started loosing some of her top teeth but know sign of them growing back. Please help.

  22. M says:

    Hello. I am distraught over my 12 year old daughter’s dental situation. She is missing 5 permanent teeth. Two permanent molars on top as well as a top front tooth, and, two permanent molars on the bottom. The ortho recommended having the four molar baby teeth pulled as the root system on all four was deteriorating. Her dentist made sure, through x-rays, that this might be an appropriate procedure and proceeded with the extractions. The front permanent tooth never formed and the ortho said once the teeth are positioned he will create a falsy retainer for the front until she is old enough for a surgical implant. She is eating alright, but, has definite and apparent problems eating. The staff at her ortho is ocassionally rude and not really very gentle. She is a special case and if my husband and myself should decide to take her somewhere else for proper care what should we look for? We live in Farmington, NM and our resources are limited. I have called our dentist for his advice and am waiting for his response. Just curious how you would handle a situation like this.
    Kind regards,
    M

  23. janine says:

    hi my daughter is missing two of her adult teeth and we were wondering what are some suggestions that will help!!!???

  24. kylie says:

    I’m 15 and missing one of my bottom teeth. My baby tooth has a cavity and it hurts. I was suppose to get it filled but my dentist said she didnt want to because it might make it looser. What should I do?

  25. Emilea says:

    Hi, I am 13 years old and have lost nearly all my baby teeth and all of them have come through perfectly apart from one of my canines. I had lost my other canine and it took ages to grow through but I could feel it, it took about a year to come through fully. But when I lost my other canine i couldn’t feel it under the gum I am aware that sometimes you can’t, it has been around 9 months since I lost it and no sine of any adult tooth. Although it had a large bump on top of hole where it is supposed to grow which happened with my last tooth. The gum has become quite hard and I am afraid that it can’t come through because the gum is too hard. Is this normal? Do you think it was too early to come through as most of baby teeth did come out later than the usual age? Thanks Emilea

  26. Lisa says:

    I just found out yesterday that my 7 yr. old is missing 8 permanent teeth. I was wondering what underlying condition may cause this.

  27. Joanna says:

    My son is nearly 8 he has lost his bottom 2 teeth but not is top two and these are getting very small from him being a grinder, he also hasn’t got any of his adult molar yet either.

  28. Courtney says:

    Hi, I am 23 years old and still have one baby tooth left. I was told my whole life that that tooth did not have any adult roots above it so that when it does fall out I will have to get a fake one put in. I take excellent care of my teeth and have never had any problems with the tooth, but recently while eating some banana chips I developed a hole in the baby tooth. Along with the small hole I now feel like the tooth is loose. I have a dentist appt scheduled in a few weeks (earliest they could get me in) but I was just wondering if you have any advise for me as to what they will do or how much it may cost. I also have all of my wisdom teeth in too, so I’m not sure if they could just pull those forward. Thanks!!

  29. Andrew Soto says:

    I’m an 18 year old-time who just got puller out canines at the top of the mouth I had my mouth bleeding so I used something to have the teeth grown back

  30. Naomi says:

    I am 21 and the teeth on either side of my front two teeth are still my baby teeth. My dentist is unsure whether I have adult teeth and has suggested that I get them taken out and get a bridge. One of the baby teeth feels loose so will have to come out soon. But if i get a bridge this will mean constant replacement every two years which may cost quite a bit. I have been very conscious of my teeth especially as I have a gap also. I am unsure of what to do are there any more permanent solutions.

  31. BWright says:

    I am missing both of my canines on the top of my mouth and all of my wisdm teeth. I’m 13. Should I be worried?.

  32. Karel Alonajan says:

    Hi Dr! :) Im a 13 year old daughter and I lost my Permanent teeth. Do it have a chance to grow back?

  33. slin says:

    hi im turning 18 in about a month and one of my back molars has been trying to grow for the past 2 years is that a problem???

  34. slin says:

    oh i also lost my baby molar probably since i was 9

  35. Kim says:

    I have an 8 year old son who has two loose baby teeth next to his two top, front, adult teeth. They have been loose for 8 months plus. He is naturally missing two adult teeth next to his two top front teeth. His one loose tooth is now slanted facing outward and he has been complaining about being nauseous over a week now. He is seeing a dentist in a few days. They suggested when his adult canine teeth come in to bring them together with his two front teeth, using braces.. I’m not sure about this? Any other ideas?

    Sincerely,
    Kim

  36. Louise says:

    My son lost his baby upper teeth, the ones each side of his middle 2 teeth many months ago. There is no sign of any new teeth but there is not much space as there is a big gap between his 2 front teeth. I thought this could be the reason but the dentist says she cannot feel any teeth in his gum but thinks she can feel them in his jaw? She has referred him to an orthodontist and said they would answer any questions. We have a 3 month wait and I was wondering if dentists can always feel the tooth in the gum or if they can sometimes be missed?

  37. Nick Meek says:

    Hi, I am Nick, I am 13 and have lost all of my teeth, or so i think. I lost my second to last molar on the top about a month and half ago. There is a piece of tooth about half the size of a popcorn kernel and it has not grown any since i lost the tooth. Is it left over fragment or is it a new tooth. I hope it wasn’t an adult tooth. Also, I am losing the same tooth on the other side of my mouth. I have been taking extremely good care of it, but it is still loose. I don’t want to lose it though because i am scared it is an adult tooth.

  38. jadyn Miller says:

    .y. my daughter lost one of her two baby teeth that will not be replaced with adult teeth. She has braces and the ortho wants to remove the baby tooth to do a canine conversion AND remove two teeth on the bottom to prevent a “bulldog” look. I really hate to remove all three teeth if not absolutely necessary. Your thoughts are very appreciated.
    Thanks

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