Expert: Tony Appleton BDS DPDS - 8/10/2007

Question
QUESTION: Dear Tony

I have two sons, one aged 4 1/2 and the other aged almost 2 years. We normally go once a year to the NHS dentist near my family, and as none of us have had problems for years this has been a good arrangement. When we visited a month ago all was well, but now I have a query about each of the boys but it's tricky to get to our our dentist as he is 150 miles away.

Firstly, one of my older son's top middle teeth has just discoloured to a grey colour. As a baby he chipped both his top middle teeth and over the years I have always found them harder to keep clean, and they have tended to look a bit more brown than the rest of his teeth, but with careful brushing, we have kept on top of this. But now, one of them has actually turned grey, so I'm guessing the nerve has died. He doesn't seem bothered by it, so I'm wondering whether it is important to get him seen by a dentist soon, or whether I can keep an eye on it myself as long as nothing changes.

Then my younger son who will be 2 in a few weeks, has almost all his baby teeth. There is only one molar still to come through and that is almost there. But when he was crying the other day, I noticed that one of his back molars looks as if it has 3 rows of points instead 2. It's hard to get a long look at it, but it looks like an extra large tooth. Could this be part of an extra tooth showing through. And again, do I need to get it seen soon? As we've seen our usual dentist recently, we wouldn't normally be going again until next summer.

Sorry this is rather long.  I look forward to hearing from you.

Regards

Sarah











ANSWER: Hi Sarah

Yes - I think you are right - the discoloured baby tooth has most likely died due to the previous trauma. If it is not giving any pain, and there is no sign of swelling or tenderness above the tooth then you should be fine to wait until you next see your dentist. Your son will lose this tooth normally in 18 months-2 years time, and there shouldn't be any long-term affects, although there is a slight chance that this can affect the permanent successor.

With regards to your younger son - are you sure he has all of his teeth? Generally his second deciduous molars won't come through until he is two to two and a half, so it could be that you are just seeing the first of his second deciduous molar teeth (his E's).

Again, don't worry - just get him seen at the normal time, unless he is getting significant pain.

Regards

Tony Appleton

---------- FOLLOW-UP ----------

QUESTION: Dear Tony

Thank you for replying so quickly. I think I'll just keep an eye on my 4 year old for now.  Does the possible risk to his permanent tooth come if the discoloured tooth becomes infected?  And is the fact that his central incisors have always been more inclined to look a bit brown linked to the trauma, or is it just that they are more exposed to food and drink on the front surface?

Yes my younger son definitely has all but one of his teeth.  He is quite relaxed about me feeling them and his gums, so I've been keeping count and he has 19 and one molar sized lump in his gum.  I know they are rather early and will be glad when the last one is through as it does cause him some discomfort.  The tooth I am concerned about is one of the back molars on his upper jaw which is fully through, and it did look normal until recently.  The extra row of points are actually to the side of his tooth, and are further into the roof of his mouth than I would expect the molar to grow. Is he too young to display an extra tooth? Again it doesn't seem to be bothering him.  

Regards

Sarah  

Answer
Hi

Yes - the risk to the permanent tooth can be from infection, or it can be directly from the trauma if the baby tooth was displaced and traumatised the developing permanent tooth directly.  I have to say the chances of problems are slim.

Your younger son could have an extra tooth, but that would be rather unusual, or it could just be extra cusps formed on that particular baby tooth. Ask your dentist next time you see him.

Regards

Tony Appleton