baby teeth in adults savina dental clinics malta and gozo

Did you know that baby teeth in adults, also known as retained baby teeth are actually quite common? In this article, we cover the reasons why and what treatment options are available.

Babies have smaller mouths. As they grow, their mouths and jaws become bigger – big enough to accommodate more teeth than the few they have by age 3. As such, the baby teeth shed and pave the way for larger and permanent adult teeth. For many kids, the milk teeth are all gone at the onset of adolescence.

The wisdom teeth erupt later on between the years of 17 and 21. From time to time, some baby teeth may prove to be stubborn and not exfoliate (fall off). The retained teeth usually do not cause problems in adults and as such are not a concern. However, in some cases, they do and signify an underlying condition.

If the second baby molars are retained until 20 years, they do not result in dental complications. However, if the first baby molars and incisors are retained, treatment might be required.

Causes of adult baby teeth

One reason why the permanent teeth may fail to force the baby teeth out is because of tooth agenesis. This is a rare condition in which some or all of the adult teeth are missing. According to a particular study, the condition is present in 6.8% of the population (1).

In some cases, the baby teeth are fused to the jaw bone, or the teeth are misaligned and crooked. Infections and traumatic injuries can also stop the permanent teeth from erupting normally.

Conditions of adult baby teeth

Hyperdontia

With this condition, adults have extra teeth. As such, there isn’t enough room for the permanent adult teeth to come forth. The extra teeth are known as supernumerary teeth. They often erupt in abnormal positions’ such as adjacent to other teeth in the arch or behind front teeth. This condition is prevalent in men than in women.

The shapes of the extra teeth include;

  • Supplemental – the extra tooth is shaped like the adjacent tooth
  • Tuberculate – the extra tooth has a tube-like shape
  • Compound odontoma – the extra tooth is a cluster of tiny tooth-like growths close to each other
  • Complex odontoma – rather than single teeth, tooth-like structures grow in a disordered cluster
  • Peg-shaped – the teeth are wide at their bases, narrow at the top and have a sharp pointed tip

Oligodontia

With this condition, six or more permanent teeth are missing, and the incisors are the most affected. However, the molars can be affected as well. In the case of molars, usually, the first molar is missing. This molar should erupt at around age 6. Oligondontia is a little more common than hyperdontia.

Anodontia

Here most of the permanent teeth (if not all) are missing. The condition is different from when a person has lost teeth by accident. Since there’s no way to stimulate the growth of teeth, dentists recommend the use of dentures at a young age, until dental bridges, and dental implants can be considered at an older age. The dental bridges can be considered if only a few teeth are missing while dentures are best when all teeth are missing. On the other hand, dental implants feel and look like natural teeth.

Luckily, on its own, anodontia doesn’t cause problems. However, if other conditions like ectodermal dysplasia come into play, you might develop problems related to skin, sweat glands, nails, and hair. But despite the complications, it’s easy to manage anodontia.

Complications caused by baby teeth

Some complications that can arise from retained baby teeth include:

  • Malocclusion – a condition where the teeth don’t line up when the mouth is closed
  • Diastema – a condition where there are spaces between the teeth
  • Infraocclusion – a condition where baby teeth remain in a fixed position even when the teeth adjacent erupt

What can I do if I have baby teeth as an adult?

In some cases, retaining the teeth is the best option for your oral health. This is especially when the teeth and their roots are still functioning, aesthetic and structurally sound.

Retaining the teeth requires minimum maintenance. Occasionally, it might result in either having too little or too much space in the future when you need some dental work done.

Dental implants

dental implants used to replace space left by removal of baby teeth in adults

Dental implants are used as replacements for damaged or missing teeth. With missing teeth, you might experience difficulty pronouncing some words or chewing food as well as shifting of the neighbouring and opposing teeth into the available space. Dental implants and bridges fix this problem.

Dental implants are a reliable solution for the replacement of baby teeth in adults since they are permanent. The process is simpler when the permanent teeth are non-existent. If they are present in the jaw bone but in an unfavourable position to be brought into place either by simply extracting the baby tooth or with the help of orthodontics (fixed braces treatment), they might need to be removed before a replacement tooth can be placed. This is very common with canines.

Extraction

In some other cases, extraction is the only solution. In these cases, two procedures are done.

Replacement

If the baby teeth are weak from decay or root resorption, a replacement is necessary. In this case, as outlined above, installing implants is the best route to take.

However, dentists don’t recommend implants for kids in their early and mid-teen years since their skeletal structure is still in the development phase. For such patients, partial dentures are recommended. This is especially true when the number of missing teeth is high, or they are developing mouth issues due to the missing teeth.

Space closure

If there is severe crowding, the baby tooth might have to be removed, and the space used to straighten the remaining teeth. However, removing teeth without a permanent replacement can cause serious dental complications later on if there is space which is not utilised. The surrounding teeth can drift again and if space is too narrow, it might be impossible to have an implant placed.

Surgery and orthodontics

When the baby teeth are structurally sound, there’s no need for replacement. The best approach is to modify the aesthetics. For this, dental veneers or crowns can be placed on the baby teeth. These give the appearance of adult teeth while maintaining the integrity of their bases.

However, retained baby teeth cannot be treated with orthodontic procedures, including fixed braces since such treatments can fast forward the root resorption process.

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Savina Clinic – Dental & Implantology Centres are friendly, state-of-the-art practices in Malta and Gozo dedicated to comprehensive quality dental care. Savina Dental is an innovative dental practice in Malta and prides itself on the high-quality customer service, low waiting room times, attention to detail and the advanced dental technology at their disposal.

Joseph Xuereb
Joseph Xuereb
Principal Dental Surgeon & Owner of Savina Dental Clinics, Dr Joseph Xuereb BChD (Hons), MFGDP(UK), MGDS RCS(Eng), FFGDP RCS(UK), FICD is a general dental practitioner with a special interest in Implant and Restorative Dentistry. Dr Joseph & the teams' full biographical information can be found here.