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Video: Implants for Congenitally Missing Teeth
Tooth Replacement Choices
Question:
Missing Adult Teeth: My 8 year old son will be missing 20 of his adult teeth most of them being molars.
He has 4 teeth on the front bottom and only 2 front top teeth. My concern is how long will he be able to keep his baby teeth, with proper care? Also what causes something like this to happen?
The denntist who informed me of this just said it happens. I also asked if he would put sealants on his baby teeth to try and preserve them for as long as I could and he said no since he didn't have any cavities.
Would this be something I should do? I have searched all over the internet and can't find out why this happened. When do adult teeth form and could it have been due to anitbiotics during that time? ... Visitor from FL
Answer:
I am sorry to hear of your son's dental problems.
You are approaching this fairly early, and this will help him to achieve a favorable outcome. Congenitally missing teeth are usually genetic, so there's probably nothing you did to cause this or could have done to prevent it.
It is fortunate that he has some permanent front teeth. He should be able to retain his baby teeth for many years. The reason that baby teeth loosen and fall out is that the developing permanent teeth grow into the roots of the baby teeth and destroy them.
When there are no permanent teeth to erupt, the baby teeth can last a long time.
You will need to be VERY dilligent about decay in the baby teeth. Sealants may help, but the worse threat is from decay between the teeth and sealants won't protect here.
I would schedule dental visits 4 times a year and be sure that the dentist takes x-rays between the teeth 1-2 times a year and uses a laser cavity detector (Diagnodent), which can spot decay 2-5 years earlier than any other tool.
I would also recommend cavity varnish at each visit. I like an Omni product called Vanish.
Your son's oral hygiene must also be excellent. I would recommend an electric toothbrush. My favorite for this is Sonicare. Remember that you will be asking teeth that should last for 6-14 years to last a whole lot longer.
You can't protect these baby teeth too carefully. Also, his diet will influence the retention of these teeth. No carbonated soft drinks should be important.
I would be sure that your general dentist is concerned enough about your son's problems to spend some time thinking through a solution. I would think he would recommend a consult with an orthodontist or several orthodontists to come up with a game plan of how to make the back baby teeth function with the front permanent teeth.
This may involve interventive orthopedic treatment to align the jaws correctly to accomodate the larger permanent teeth with the smaller baby teeth. A good orthodontist may involve an oral surgeon in this process.
One thing to consider with an orthodontist is how your son reacts with him. My child had jaw alignment problems and started orthopedic orthodontic treatment at age 5 that involved removable appliances and strict adherence to wearing them. The orthodontist had him sign a contract to comply (at age 5!) and laughed and teased him so much that he was very compliant. You want a serious orthodontist who can make the relationship fun for your son.
Finally, dental implants, although expensive, are very predictable and may offer a solution for your son when he is older.
I don't know how far you live from a dental school, but it might be worth the effort to have a multidisciplinary consult there. I would not have dental students do the treatment. Most dental schools have clinics where the instructors practice, and the different disciplines can work together easily.
You have a long dental road ahead of you and it will be expensive. You might do some planning now to look for financial help from your medical insurance. Your dental professionals should help you to have your medical insurance view this as a medical problem, not just a dental problem.
Having twenty teeth missing is alot. Your son could also have a systemic disease, or a recessive gene that would show some symptoms but not all. You may want to have a thorough physical examination and maybe some genetic studies.
Some diseases that include numerous missing teeth are:
- Ectodermal Dysplasia
- Osteogenesis Imperfecta
- Dentinogenesis Imperfecta
If there is some systemic disease or trait, this could explain the missing teeth and, perhaps, find other problems that should be addressed. Hope this helps. Good luck to you.
Corinne Scalzitti, DMD, MAGD
Austin Reconstructive Implant Dentistry
3900 RR 620 South
Austin, Texas TX 78738
(512) 263-3330
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