It is night time, my six year old daughter is standing on a stool in front of the bathroom sink. I just finished brushing her teeth. I am looking at the same situation I noticed a month ago. A permanent lower front tooth is erupting behind the baby tooth. Every night I test the mobility of the baby tooth and I ask myself a question every parent must ask, “When will this tooth fall out?” “Should I be concerned that the permanent tooth won’t move forward?”
Labeled as the dental expert in the house, it is my responsibility to clear plaque and administer fluoride on a morning and nightly basis. I play an important role in helping to create and reinforce a positive oral health experience for all of my children. I get a daily experience watching the development of a child’s dentition and notice changes such as tooth eruption, movement of teeth, staining of pits and fissures, and the eventual loss of baby teeth. It’s amazing from a development point of view.
Now, I have seen the evidence which suggests that by the age of 8 years old, 95% of the cases spontaneously take care of themselves. Authors suggest that if the diagnosis is made before that age of 7.5, there is no need for extraction since the problem should resolve.
I agree many factors have to be taken into consideration, such as mobility of the baby tooth, resorption of the baby tooth root, as well as parental feelings. I have realized that this last consideration is quite important!
Checking the mobility of the baby tooth nightly, it remains very loose, but not making progress. My daughter’s permanent central incisor was 1mm behind the baby incisor with more than half of the crown erupted. The mobility in the baby tooth was starting to cause some irritation. This was all I needed, call the tooth fairy!
A little Benzocaine, some gauze, the tooth was out in less than 10 seconds, very little tears that stopped quickly once it was learned that losing a tooth can be a money making venture!
In just a few weeks, the permanent incisor had moved forward and into correct position. Maybe I should have trusted more in the evidence. As a parent, I wanted the tooth out. I knew that the extraction would be a quick and easy fix.
It is a few months later and my daughters top front teeth are extremely loose, with no discomfort. My daughter came home from school the next day, tooth in hand, with a giant smile!
Have a loose tooth that just won’t fall out? Are front teeth coming in behind the baby front teeth? Call us at Peak Pediatric Dentistry to schedule an evaluation; we will do a full developmental exam as part of our normal new patient exam and cleaning!