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Dentistry/delayed permanent teeth

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Expert: - 11/20/2008


Question
Dear Dr. Moss,
My oldest son, aged 12 1/2, has only lost 7 teeth thus far, the top front four and the bottom front three with the fourth just left of the centre two still in place and not loose.  X-rays reveal a permanent tooth that is still  down in the bone. The canine beside indeed has risen just slighty above it in the xray in terms of a pending eruption. Further, comparatively the permanent tooth has not changed in location since films were taken 3 years ago.  At this point they want to pull the tooth to see if that stimulates the permanent tooth to begin to put down roots and push up.  Failing this in 3 -4 months they wish to put braces on the bottom teeth and put a bottom on the permanent non-erupted tooth and slowly pull it up over time.  Thoughts as to the suggested plan of care would be muchly appreciated.  Could the baby tooth simply be left in place instead.  Does pulling the tooth work in "encouraging" the permanent tooth to come up or do they often need to go the braces route.

Thanks so much again

Lisa

Answer
Dear Lisa,
The best way to encourage a permanent tooth to erupt is to extract the baby teeth.
You should have that done as soon as possible.
Teeth grow in spurts, called growth spurts and when your son has his next growth spurt you dont want to have the baby tooth in the way of the erupting permanent tooth.
Pulling the permanent tooth into place with an appliance is something that I cannot comment on without having the opportunity to examine your son and look at his x-rays.
Hope this helps,
All the best,
Dr. Moss

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Stephen J. Moss

Expertise

I am a professor emeritus at New York University, with a background that includes extensive research, scientific writing and biology. I also am an international consultant in health education, particularly in developing education on new science for health professionals and consumers. I am a past president of the American Academy of Pediatric Dentistry, former head of the NYU Division of Oral Biology and I represent the World Dental Federation at the United Nations. I travel around the world to provide health education to professionals and consumers.

Experience

Having retired from New York Universit, where I directed the pediatric dentistry training program, a walk-in dental clinic and research on oral biology, I formalized my professional and consumer health education initiative in the form of Health Education Enterprises. This entity consults and provides information on new science pertaining to oral and general health, particularly leading edge concepts that can be employed in the health professions to improve the public's health. As such, I am an expert in communicating new science and its usefulness to professional and lay audiences alike. I also had a pediatric dentistry practice in New York City for nearly 30 years.

Organizations
I am affiliated with the American Dental Association, the World Dental Federation, the International Association of Pediatric Dentistry and the American Association of Pediatric Dentistry among other formal organizations. My experience has included a research fellowship at the National Institutes of Health and work at the Forsythe Dental Research Center

Publications
lpha Omegan USA, Nowa Stomatologia Poland, Journal of Public Health Dentistry, The Journal of the Southeastern Society of Pediatric Dentistry USA, News Bulletin Japan, Journal of Marmara University Dental Faculty Turkey, Italian Journal of Paediatric Dentistry Italy, Asian Dentist Singapore, The Journal of the Israel Dental Association Israel, ROBRAC Brazil, Italian Journal of Paediatric Dentistry
Italy, FDI World, STOMA Portugal, Pediatric Dentistry The Philippines, Modern Stomatology Bulgaria, Journal of the Indian Society of Pedodontics and Preventive Dentistry India

Education/Credentials
I obtained a doctor of dental science (DDS) degree, a master of science degree and am a board certified pediatric dentist.

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