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Oral Surgery/Adult tooth did not come down


Hi.  My 14 yo daughter still has a baby tooth (tooth beside canine, towards the middle).  I have had dentist look at it and take xrays and cat scan and he has said that the adult tooth is lying almost horizontal towards the front teeth, most awkward position he has seen for quite a while.  He has recommended we try to use braces to space out the teeth then using surgery, cutting some on the bone away then 'lassoo' the adult tooth and try to bring it down before closing the spaces.  He has said it will be probably a 3 year process trying to bring the tooth down then trying to get the tooths roots in the correct position so she will have no further problems.  He has also mentioned that we may run into trouble with it disturbing the surrounding teeth shortening the roots on those teeth and that the the adult tooth may actually be fused to the bone so may not be an option.  I know its difficult but Im wanting a second opinion.
Thanks in advance for any light you may be able to shed.

Jo - Your daughter's situation is one of the most difficult to come up with a plan that will definitely work.  By the age of 14 your daughter's bone has started to become more dense as she gets closer to the end of pubery (about 16-17).  The key factor is the tooth's position.  Without seeing an xray, it is a little difficult for me to be sure.  To be safe, you should have your daughter examined by an oral and maxillofacial surgical specialist and an orthodontist.  The surgeon has a better idea of the ability to move the tooth in the bone position, but the working together of the two specialists can come up with a percentage chance of success.  It is important not to put your daughter through a lot, if the chances of success is not great.  So have her examined by a specialist to get a better perspective of success and possible alternative approaches.

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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon 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 practicing for over 20 years. Assistant Clincal Professor at 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 Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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