Common reasons why your child’s permanent teeth aren’t coming in

Losing baby teeth is a big deal for young children. It is one of many milestones in their consistent (and much too fast for parents) march toward adulthood. However, the excitement can turn worrisome when permanent teeth don’t come in at expected times.

Most kids lose their primary teeth at around age 6 and the process continues to roughly age 12. After that, permanent teeth erupt in as little as one week or as long as six months. While a slower growing permanent tooth is typically nothing to worry about, if it takes longer than six months, you should visit an orthodontist or dentist to evaluate the issue and discuss potential solutions.

Reasons for a child’s permanent teeth not coming in, or erupting, in time vary among individuals but we can point to a handful of causes that make frequent appearances:

Losing primary teeth too early

Primary teeth are very important and one of their vital roles is saving space for permanent teeth. The usual scenario is a baby tooth falls out because the permanent tooth is starting its eruption, pushing out the baby tooth in the process. But if a baby tooth is lost early and the permanent tooth isn’t ready to fill the void, other teeth tend to shift toward the empty space.

This can lead to misaligned teeth and left unchecked, severe cases may require oral surgery. Good oral hygiene is excellent prevention against misaligned teeth but if your child loses a baby tooth too early, it is best to see your dentist for advice.

Not enough space

There must be sufficient space available for a permanent tooth to erupt; ideally with room on both sides of baby teeth to accommodate wider permanent teeth. While many parents believe baby teeth should look perfectly straight and aligned like a battalion of soldiers, that is not the case. You should see small gaps between all of your child’s front baby teeth.

Growing in the wrong direction

Another reason permanent teeth do not erupt is because they grow in the wrong direction. This is most common with lower bicuspids and upper canines. However, sometimes even with adequate space, permanent teeth can veer off track. To correct this, dentists can intentionally remove baby teeth, or provide specific orthodontic treatment.

Impacted teeth

Some children have impacted teeth that prevent adult teeth from erupting. This can result from narrow jaws or premature loss of primary teeth. Without sufficient space to erupt, permanent teeth will develop below the gums, causing an array of oral issues. If addressed promptly, dentists can use a radiograph to locate a tooth’s position and correct it if needed.

Presence of supernumerary teeth

Children have 20 baby teeth and adults typically have 32 permanent teeth. Sometimes, however, extra teeth develop in a condition known as hyperdontia. This leads to supernumerary teeth and a range of problems including crowded or impacted teeth, displacement or misalignment of teeth, and fused teeth. Supernumerary teeth can also prevent permanent teeth from properly coming in. Gender can influence this scenario as well, with variations of development between boys and girls. Following a similar trajectory as experiencing puberty earlier than boys; many girls will develop permanent teeth up to six months earlier than boys. 

Nutrition

Your child’s nutritional habits can also impact the development of their teeth. Remember that teeth need a lot of calcium and other minerals to stay strong enough to push through the gums. A high-sugar diet detracts from that strength and parents should be sure their children stick to a healthy diet and learn how that diet can make a big difference in their lives.

Treatment options

In addition the above reasons for delays in permanent tooth eruption, heredity can also play a role in the ages some children lose their primary teeth and develop adult teeth. For example, if your teeth came in late, there is a good chance your child’s teeth will follow the same path. If your teeth grew slowly or you needed braces, the same will likely happen with your children. Remember, if your child’s permanent teeth have not appeared as expected, contact your dentist to discuss strategies to correct the issue and allow your child’s teeth to grow without impedance.