It's the "Case of the missing tooth!" Quick, call CSI, or Marcus Welby, M.D., or maybe Sherlock Holmes … "Help! we've got to find out where that permanent tooth is" … "I don't see it," you say as you struggle to look upside down into your child's mouth … "when is it going to come in?" Yes, that IS a great question! You might also want to be asking one you might not have thought to ask at all … "will it EVER come in?"
Reasons a Child's Tooth Might Not Erupt On TimeTooth eruption is a complicated thing. In fact, the reasons as to why and when a tooth enters the visible world of our mouths are so complex that people who study the topic are still called "theorists!" That's some complicated stuff. So, let’s un-complicate it a bit and take a look at the two reasons you're most likely not seeing a permanent tooth replacing the primary tooth the tooth fairy now has in her possession.
First off, your child could merely be experiencing what is referred to as "delayed eruption." This can be caused by all sorts of things including a mouth that is already a bit crowded, dietary inadequacies, illness, or genetics. So, if seems like you’ve spent months waiting for that tooth and are starting to get worried, schedule an appointment to see your dentist who can give you an idea as to what's happening in your child's mouth. Most likely the tooth will present itself when it’s ready … much like our kids do when they're preparing a mini-play for you and your relatives in the living room. It takes time.
The other reason you might not see a permanent tooth peeping through your child's gums just might be because it’s congenitally "missing." In that case, you might want to pull up a chair, or maybe a recliner, because if that's the case, the tooth you're looking for won't ever come in, and you'll be waiting a rather long time. All the more reason to consult with your dentist if you're at all concerned. Believe it or not, though, such failed eruption of a permanent tooth is a fairly common condition, with some reports suggesting nearly 20% of all adults are congenitally missing at least one tooth.
Should your child have a congenitally missing tooth and reaches an age where surgery is an option, you may wish to consider a dental implant to serve as a replacement tooth for the one that does not appear. Also, non-surgical options such as a bridge or a partial denture can also be good solutions. In most cases, when it’s appropriate, your dentist will suggest some sort of space maintainer to prevent the shifting of other teeth, so this is something worth thinking about as time goes by.
The good news is, there are solutions for each concern, and knowing what you're dealing with is the best first step in the right direction, so do bug your dentist - they're always happy to help!