My son is 31 and still has a baby tooth with no adult tooth under it.  The dentist frequently says he should remove the baby tooth and get a bridge or an implant.
1.  How does one decide on a bridge or an implant?
2.  My son would like to do nothing.  Is there an issue with the baby tooth remaining in his mouth?

THank you for any help you can give.


Lauren -  First of all, the decision to extract a baby tooth when no permanent tooth is underneath to replace it usually is made if the tooth is decayed, loose, out of position or if the bite is bad because of the baby tooth.  If the tooth has been determined to be extracted, a replacement decision is made based on the position of the space created by the loss of the baby tooth, the soundness and presence of decay on the teeth on either side of the baby tooth and the importance of the baby tooth in the overall bite.  A replacement can be made via an implant, a bridge or a removable partial denture (flipper).  The decision on which type of replacement needs to be made based on appearance of the area and the structure of the replacement to support the bite.  

Your son could do nothing and leave the baby tooth in place if there is no decay, a collapse of the teeth on either side has not occurred and if cosmetic appearance is not important.  As long as the baby tooth is sound, not movable and can be properly cleaned so the teeth on either side will not be more prone to develop decay, periodontal disease or looseness.

So, without seeing xrays or examining your son, I cannot give an honest decision on my part as to what is the correct approach.  So it is up to your son, but if the dentist says that the teeth on either side could potentially be in trouble, a replacement is most likely correct.


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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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