It’s normal for children to experience pain and discomfort as their adult teeth begin to grow. However, if the process of permanent teeth eruption becomes problematic, it could be a sign of an underlying issue. In this article, we’ll discuss what permanent teeth eruption problems are and some of the potential causes.
What Is Permanent Teeth Eruption?
Permanent teeth eruption (also known as exfoliation) is the process by which adult teeth replace primary (or “baby”) teeth. This usually starts around age 6, with the molars and maxillary canine appearing first and continuing until age 12-13, when all of the permanent teeth erupt.
What Are Permanent Teeth Eruption Problems?
Eruption problems can occur when there is a delay or blockage in the normal tooth development process. The most common eruption problem is called impaction, meaning that one or more permanent teeth may be blocked from erupting because they are positioned poorly, or there isn’t enough space between them. Other issues include premature loss of baby teeth and non-eruption due to infection or trauma.
Most people will have an uneventful teeth eruption. However, some may face issues such as:
Delayed eruption
A delay is when a tooth erupts significantly later than the average population’s eruption time. It can also be considered when there is an isolated disruption in the eruption sequence. The generalized delayed eruption can be seen in some babies born prematurely, born with low birth weight as well as in malnourished children. Some children with medical conditions such as Down Syndrome may also present with this condition. Conditions such as when there are extra teeth, inadequate space in the arch and unusually firm gums can cause localised delay involving a few teeth.
Early eruption
Some babies have teeth that erupt early in life, called ‘natal teeth’ and ‘neonatal teeth’. They are part of the primary dentition and usually appear at the front part of the lower jaw. Sometimes these teeth will need to be removed, such as when there is a risk the teeth will fall off and when they are associated with feeding difficulties. Patients with a medical condition such as Hyperthyroidism and early puberty can also present with early eruption of teeth.
Non-eruption due to teeth that are not present
Missing teeth or hypodontia happens when there is a failure in the development of teeth. The absence of teeth can range from missing just one tooth to missing all teeth. Hypodontia can occur in healthy patients or can be associated with patients with conditions such as cleft.
Additional teeth
Some individuals may have an extra number of teeth, such as supernumerary teeth. They can occur in normal people or can be associated with patients having medical conditions. A possible consequence of having an extra tooth is that it can lead to crowding and delayed eruption.
Abnormal tooth structure
Malformed teeth may influence eruption. An example is a dilacerated tooth, where the roots are formed at a different angle to the axis of the tooth. In severe dilacerations, the tooth may not be able to erupt. Factors that can cause malformed teeth include trauma or conditions such as the effects of chemotherapy.
Malocclusion
Generally, it describes teeth that are not well aligned. Primary teeth tend to be spaced. However, spacing and crowding of permanent teeth may need thorough consultation by dental professionals. The ‘ugly duckling phase’ is a temporary, aesthetically-unpleasant phase when children go through the replacement of their front primary teeth. Large teeth in a small-sized jaw commonly cause crowding, which can lead to eruption problems.
Teething
Teething is the process where teeth sequentially appear by emerging through the gums. Some infants exhibit signs of distress such as crying, increased drooling, fever, facial rash, sleep difficulty, mild pain and diarrhea. Some babies will refuse to eat and drink. There is neither universal agreement nor strong scientific evidence to support teething issues.
Oral pathology
An eruption cyst is a soft, round swelling that occurs on the soft tissue overlying an erupting tooth. Most will burst spontaneously, needing no treatment. Pericoronitis, or inflammation of the soft tissues surrounding an erupting tooth, can be associated with a wide range of symptoms, including severe pain, trismus, swelling and fever. Some cysts are related to teeth, such as radicular and dentigerous cysts. Multiple tumors or cysts in the jaws, as seen in some medical conditions, might lead to generalized delayed eruption
Causes of Permanent Teeth Eruption Problems
The specific causes of eruption problems can vary greatly, but some of the most common culprits include:
Poor dental hygiene
If plaque isn’t removed regularly from around an emerging tooth, it can cause a blockage that prevents further growth.
Missing primary (baby) tooth
When a baby’s tooth falls out prematurely due to decay or other factors, it can disrupt the alignment of permanent teeth and lead to problems with their eruption later on in life.
Genetic disorders
Some genetic syndromes, such as Down syndrome, can cause physical deformities that make it difficult for adult teeth to develop correctly and lead to impaction or misalignment later down the line.
Abnormal development
It’s normal for children’s jaws to develop unevenly during the teething process, but abnormalities in jawbone growth can interfere with the proper alignment of adult teeth and lead to impaction or noneruption issues later on in life.
Diagnosing Permanent Teeth Eruption Problems
In order to diagnose an eruption problem, it’s important for your dentist/orthodontist to take X-rays and look at your child’s mouth closely for any signs of misalignment or impacted teeth. They will also ask about family history, diet habits and other lifestyle factors that could have contributed to your child’s condition. Based on their findings, they may recommend certain treatments, such as orthodontic braces or corrective surgery, depending on the severity of their condition.
Treating Permanent Teeth Eruption Problems
The treatment plan for each patient will depend on their specific needs; however, some more general treatments include orthodontic braces, which help adjust misaligned jaws/teeth so that they can properly align within their sockets; extractions which involve removing impacted or extra permanently grown molars; and corrective surgery which helps widen narrow arches so that all erupted adult teeth have enough space within your child’s mouth structure to fit comfortably without pushing against each other too much (this includes widening small underbites).
Depending on your child’s circumstances, follow-up appointments may be recommended for monitoring purposes after these procedures have taken place in order to ensure optimal results are achieved over time with minimal side effects or risks associated with long-term dental health concerns like TMJ Pain Syndrome (TMD).
In conclusion, understanding what is causing your child’s eruption problems is key in designing an effective treatment plan so that they won’t experience further discomfort throughout adulthood due to poorly aligned typical dentition patterns caused by impaction/non-eruption issues during infancy/childhood stages, respectively!
References:
https://www.childrensdent.com/fun-stuff/our-blog/4-tooth-eruption-issues-in-children
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5034090/
https://www.sciencedirect.com/topics/medicine-and-dentistry/tooth-eruption
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