As your children grow, they gradually lose their baby teeth, which are formally known as deciduous teeth or primary teeth.
This is a normal part of human development, and for kids it can be exciting — especially when the Tooth Fairy brings them a few dollars per tooth.
These primary teeth form in the womb prior to birth, and erupt when your child is still an infant. Over time, they loosen and fall out, to be replaced with new permanent teeth.
But what if your child reaches their teenage years, but still hasn’t lost all of their baby teeth? For many reasons, baby teeth don’t always fall out on schedule. They can be lost early from trauma or dental disease, or they can linger much longer than usual.
When Do Most Children Lose All Their Baby Teeth?
The majority of children start losing baby teeth around age six, and have lost all of their baby teeth by age twelve. As the new permanent teeth begin to develop, they cause root resorption in the primary teeth. The old teeth are being attacked by osteoclasts, a type of bone cells that destroy other bone tissue. This process destroys the roots of the primary teeth and allows them to simply fall out naturally.
Sometimes, a child will reach age eight or even ten, and still won’t have lost any baby teeth. This is the point at which parents often become concerned. In most cases, this isn’t anything serious. However, there are some situations where a dentist may need to intervene.
- The primary teeth are causing problems for the new permanent teeth
- The child’s 12-year molars already erupted
- Delayed tooth loss would mean the child’s orthodontic treatment, like braces, would occur at an older age that would be awkward for them
It is possible for an adult to still have some of their baby teeth. However, it’s quite rare. The etiology of over-retained primary teeth isn’t particularly well understood. It probably has a genetic component, but environmental factors and endocrine disorders may also play a role.
Treating Over-Retained Baby Teeth
If your teenager still has their baby teeth, you’ll need your dentist to carefully assess their oral health with a comprehensive clinical exam and x-ray imaging. They’ll examine the shape, color, position, and composition of the retained primary teeth. It’s possible that your child may have dental ankylosis, where the baby teeth have actually fused to the bone, preventing the primary tooth from erupting. It’s also possible that the permanent tooth isn’t there, so nothing is pushing on the root of the primary tooth.
Primary teeth can also be retained for other reasons, including trauma, pathology, obstructions, or misalignment of the permanent teeth beneath them.
If your child has multiple over-retained primary teeth, they may need to see an orthodontist to develop a treatment plan. If the tooth is fine structurally and aesthetically, it can be retained. If not, it can be reshaped. However, if it’s crooked it may be better to extract it, then replace it with a fixed bridge or a dental implant. Early treatment can improve your child’s outcome.
What to Do About Your Teenager’s Baby Teeth
If your teenager has retained one or more baby teeth past the age of twelve, you should talk to their dentist about it. They may be able to simply keep the baby teeth, or they may need to be extracted and replaced with an implant. It depends on the state of the baby teeth, as well as whether or not there’s a primary tooth underneath it waiting to erupt.