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Dentistry/Fused secondary tooth??

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Expert: - 12/3/2009


Question
Hi Dr.
My 3 1/2yo had a routine exam w/ x-rays today. All went well except the Dentist said that the secondary left upper central and lateral incisor seemed fused. The dentist will recheck the x-ray in 1 year. How common is this, what causes it, and what can I expect for his future dentistry needs? There seems to be little published on this topic. Thanks in advanced.

Answer
I find it rather difficult to diagnose a fusion of developing permanent incisors from an x-ray on a 3 1/2 year old youngster.  The film is a 2 dimensional image of overlapping structures so it's just not possible to know if two structures are close to one another or are actually joined.  Still, fusion of incisors is rare but we see it from time to time.  There is no particular cause, syndrome or disease that causes this.  It just happens, and when it does it may result in an esthetic challenge or perhaps it may create a problem with the bite or alignment of the teeth.  When this is the case it is necessary to have input from the dentist as well as an orthodontist for proper management of the situation.  Each situation is unique and must be evaluated on the basis of bite development, facial development and jaw growth, tooth size and shape, and many other factors.  In some cases of incisor fusion there may be some interference with the usual emergence of permanent teeth so that should be carefully monitored by the dentist on a regular basis.  Usually every six months is considered adequate.

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Dr. Randolph Myerson

Expertise

Please limit your inquiry to questions about orthodontics (braces) and children's dentistry. I am both an Orthodontist and a Pediatric Dentist, having been trained in both of these dental specialty fields. Orthodontics is the dental specialty that treats problems of tooth, bite and jaw alignment using braces and removable appliances. Pediatric Dentistry is the dental specialty also known as dentistry for children, which deals specifically with the dental problems of this special age group from infants to adolescents. I am also experienced in Forensic Dentistry, the application of dentistry to law enforcement and identification using dental records.

Experience

I have been in the private practice of orthodontics and pediatric dentistry for over 20 years. Prior to that I served for three years on the Cleft Palate and Cranio-facial Reconstruction team at Children''s Hospital of Philadelphia and was an Assistant Professor of Dentistry at University of Pennsylvania School of Dental Medicine. I also served as a dentist in the U.S.Air Force, stationed at Andrews AFB in Washington, DC.

Organizations
I am a Fellow in the American Academy of Pediatric Dentistry, and a member of the American Association of Orthodontics, as well as a member of the American Dental Association and the Dental Society of the State of New York.

Education/Credentials
I received my BA in Biology from Frankin & Marshall College in 1969, and my dental degree from University of Pennsylvania School of Dental Medicine in 1973. In 1978 I received both my Certificate in Orthodontics from University of Pennsylvania School of Dental Medicine, and my Certificate in Pediatric Dentistry from Children''s Hospital of Philadelphia after completing a three year Teaching Fellowship in Orthodontics and Pediatric Dentistry in 1978.

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