What do we do when the permanent tooth erupts and the baby tooth has not fallen out?

The primary teeth (commonly known as 'baby teeth') begin to erupt between 4 and 6 months of age, so that some of them accompany the child until they are approximately 12 years old. Throughout this period, they coexist teeth permanent and deciduous teeth in the mouth, either because molars erupt (i.e. erupt) that have no milk teeth predecessor, or because deciduous teeth fall out and are replaced by permanent teeth.

Approximate chronology of dental eruptive sequence
Approximate chronology of dental eruptive sequence

Generally, when the permanent tooth begins the formation of its root inside the maxilla or mandible, it begins its process of rash. On its way into the oral cavity it encounters an obstacle: the root of the primary tooth. In order to erupt, the permanent tooth reabsorbs the root of the milk tooth until the latter falls out and makes way for its successor.

But sometimes we find that the permanent tooth has already appeared in the mouth and the temporary tooth has not fallen out, so that both are "double-queued".

Why is this happening?

The germs of some permanent teeth (mainly the lower incisors) are located behind the baby teeth and migrate forward when they begin to erupt. If the roots of the baby incisors are inclined, the permanent tooth that tries to erupt will reabsorb them, and the crown of the baby tooth may remain intact.

Apparently the situation is normal, but the crown of the deciduous tooth is taking the place of the permanent tooth that has erupted behind it. In these cases, the extraction of the crown of the primary tooth is very simple, as well as important to ensure that the permanent teeth erupt normally.

Apparently, the situation is normal?
Apparently, the situation is normal?
...but the permanent tooth can be seen behind the temporary tooth, "in double file"...
...but we can see the permanent tooth behind the temporary tooth, "in double file"....

 

The procedure is carried out by the application of local anaesthesia around the crown of the tooth to be removed so that the patient does not feel any discomfort.

Local anaesthetic application
Local anaesthetic application

 

Extraction is quick and easyand does not cause any discomfort. The gum will heal in a short period of time.

Removing the gale is simple and quick
Removing the gale is simple and quick

 

As we have already mentioned, the root of the baby tooth has been reabsorbed by the permanent tooth during its eruption. we only see the crown.

As a large part of the root has been resorbed, we only see crown
As a large part of the root has been resorbed, we only see crown

After the extraction, we recommend having a drink cold to make it easier for the small bleeding gum to stop and for the child to feel completely comfortable.

If there is sufficient space, we will gradually observe that the permanent tooth takes its place in the dental arch thanks to the tongue thrust, without the need for orthodontic treatment.

Dr. Clara Serna Muñoz

Degree in Dentistry

Master's Degree in Paediatric Dentistry

 San Rafael Hospital in Madrid