partially erupted 2nd molar

[swiminh2o]

---

Members do not see this ad.

My three year old daughter has had a partially erupted left maxillary 2nd molar for the last 14 months. All of her other molars have erupted just fine but this one is barely through. You can visualize the entire occlusal surface but the mesial, distal, palatal, and buccal surfaces can not be seen. It is like the occlusal surface is flush with the gum line. Any explanation for this? Should I be concerned? 😕

 

[grtuck]

I hate to be ambiguous, but the best thing (and most accurate) is to go to your dentist (or wait till classes start and let your faculty look at her) and let them take radiographs and do a clinical exam.

It's possible the tooth fused to the bone (ankylosis) or there may be something else that has stopped eruption of the tooth 🙁

It is also possible (and hopeful) that nothing is wrong at all. Even if the tooth is ankylosed, it will probably shed just fine when the permanent tooth comes in and there wouldn't be any real concern 🙂

But again, the only way to really know what is happening is to look at it (clinical exam), and radiograph it.

grtuck

 

[DDSSlave]

Several possibilities but the most likely is that it's ankylosed - the root has fused with the bone. I would make an appointment with a pediatric dentist. They can tap on the tooth to check for ankylosis and they may take x-rays to look into other possibilities. I wouldn't be overly concerned, but you should get it checked out.

 

[DDSSlave]

Just to clear a few things up,

If it is ankylosed it will have to be extracted eventually. It's unlikely it will just shed/exfoliate. Usually ankylosis can't be definitively diagnosed on an x-ray. You use sounding. Please correct me if I'm wrong.

 

[UBTom]

Yep, an ankylosed deciduous tooth should be extracted at an appropriate time to allow for the permanent tooth underneath it to erupt.

to Swiminh2o: You might want to check the occlusion too-- Have your daughter bite together and see if that tooth is in contact with its opposing lower. If it is, that might be as far as it will erupt.

HTH!

 

[grtuck]

I'm not so sure that it will HAVE to be extracted,

According to "Contemporary Orthodontics" Third Edition:
(this can be verified on page 430 of the text book)

"Ankylosed primary teeth with permanent successors pose a potential alignment problem for the permanent teeth. Although they usually resorb in the normal manner without creating long term problems, occasionally they are retained by an attachment in the cervical region and are not exfoliated on schedule....Appropriate management of an ankylosed primary tooth consists of maintaining it until an interference with eruption or drift of other teeth begin to occur, then extracting it and placing a space maintainer..."

It also references a study done by Kurol and Thilander in the Journal of Orthodontics 6:277-293, 1984 to support this.

Of course I have NO empirical evidence of my own to support this, but I know that this is the philosophy we have at UNC. This way the tooth will serve as a space maintainer as long as possible, and LIKELY it will exfoliate without any real sequelae. Other schools may have other philosophies (nothing wrong with that), but I wanted to share my limited view. 🙂

Also, Good point DDSSlave about sounding the tooth. 👍

grtuck

 

[DDSSlave]

...Appropriate management of an ankylosed primary tooth consists of maintaining it until an interference with eruption or drift of other teeth begin to occur, then extracting it and placing a space maintainer..."

I completely agree with this statement. Good reference grtuck. It's nice to discuss some actual dentistry in the dental forum every once in a while. 🙂

 

[grtuck]

It is kind of nice to talk dentistry once in a while isn't it? Of course if you ask my wife I talk too much about it (I must like it a little bit 😀 )!

Swiminh2o, keep us up to date on what happens with you daughter. I would be interested to see what you do/learn. Are you still in Utah, or have you moved yet?

grtuck

 

[tooth_sleuth]

if the tooth is extracted, don't forget to use a space maintainer!

 

[swiminh2o]

It is kind of nice to talk dentistry once in a while isn't it? Of course if you ask my wife I talk too much about it (I must like it a little bit 😀 )!

Swiminh2o, keep us up to date on what happens with you daughter. I would be interested to see what you do/learn. Are you still in Utah, or have you moved yet?

grtuck

I've lived in Washington for several years but did go to BYU ('95 BS, '97 MS) Go Cougs!. Thanks everyone for your input. I've debated taking her in to see our dentist or just wait till I get to school. Sounds like from your collective posts that waiting to consult in school will not compromise her.

Just to clarify, what is "sounding"? I'm imagining tapping on a wall to "sound" for a stud behind the drywall. Is this kinda what your talking about with a fused tooth, it sounds different when tapped?

Thanks again for your posts. 🙂

 

[grtuck]

Yes, you tap on the tooth with the back of your mirror (the handle end) or something similiar and IF it is ankylosed, it has a distinct sound to it.

grtuck

 

[DDSSlave]

Yes, you tap on the tooth with the back of your mirror (the handle end) or something similiar and IF it is ankylosed, it has a distinct sound to it.

grtuck

👍