The process of losing primary teeth actually follows a specific timetable starting with the front two bottom teeth and going back and forth from top to bottom with the primary molars being the last to go. There may be some exceptions but most children have lost all of their primary teeth – the wisdom teeth don’t erupt until much later – by the age of ten or twelve. If this course of action is interrupted there may be cause for concern. A permanent tooth that has still not erupted one year after it was due may be considered to be “over-retained.”
The permanent teeth are guided into place by the primary teeth. When a permanent tooth is ready to erupt it will push the primary tooth out and move into place. If the permanent tooth has somehow become misaligned or if it is diseased it may not be able to erupt as it should. It could also be that there simply is no permanent tooth which is the more likely case.
Your pediatric dentist will want to take x-rays and do a thorough clinical exam to find out what’s holding things up. Early loss of a primary tooth can impede the normal transition but if it is blocking the way for the permanent tooth it may be best to have it extracted. Your dentist can make that evaluation.
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