tooth agenesis

WHAT IF YOU'RE 13 YEARS OLD AND you still have a baby tooth? A baby tooth at age 13 indicates an orthodontic and dental health problem.

Baby Teeth Shouldn’t Be Present After Age 13

Most children lose their last baby tooth by age 12. Girls can be up to two years earlier than boys and lose their last baby tooth by age 10. Boys could lose their last baby tooth as late as age 13. In either case, boys or girls, baby teeth present after age 13 are cause for concern.

If you or your child are over the age of 13 and still have a baby tooth, it is important to have an orthodontic examination with an orthodontist as soon as possible.

4 Possible Problems of a Baby Tooth at Age 13

#1: Your baby tooth is stuck to the bone (ankylosed).

It will not fall out on it's own. The permanent tooth below is unable to push the baby tooth out. This baby tooth needs to be extracted as soon as possible.

#2: The baby tooth is mechanically blocked from falling out.

It is obstructed by crowded side teeth. It can't make an exit, like being too wide for a doorway. There is crowding and braces are needed to allow the baby tooth to fall out or be extracted.

#3: The permanent tooth below is crooked, malpositioned, or sizeways and can't push the baby tooth out.

The permanent tooth in the bone under the baby tooth is is in a poor position and will never come into the mouth without orthodontic treatment. Even if the baby tooth is extracted the permanent tooth will not come into the mouth. Your orthodontist and oral surgeon can bring this impacted permanent tooth into position by removing the baby tooth, exposing the permanent tooth, and then moving it with braces into the mouth.

#4: A permanent tooth is missing.

Below the baby tooth there is a missing permanent tooth. You have tooth agenesis (congenitally missing tooth). You will need to maintain this baby tooth as long as possible and replace it with a dental implant or bridge in the future.

We're Here To Help!

If your general dentist has told you or your child that there is still a baby tooth at age 13, see an orthodontist as soon as possible. To find an orthodontist in you area, contact the American Association of Orthodontist at www.mylifemysmile.com.

At 13 years old, you're not a baby any longer. Take care of your last baby tooth today to find out how you can restore dental health.

Follow Dr. Gorczyca on Twitter @drgorczyca
Gorczyca Orthodontics, www.clubbraces.com.

CHARLES DARWIN FIRST DOCUMENTED the incidence of missing teeth:

“..in a Hindu family in Scinde...ten men, in the course of four generations, were furnished, in both jaws with only four small and weak incisor teeth and eight posterior molars.”

Father’s X-Ray

Tooth Agenesis May Be More Common Than You Think

The incidence of tooth agenesis “lack of development” of teeth ranges from 1.6% to 9.6% in the general population excluding third molars. The term “congenitally” missing teeth, commonly used in dentistry, is a misnomer since permanent teeth are not normally present in the mouth at birth.

Maxillary laterals incisors have been noted to be the most frequently missing teeth when only one or two teeth are absent. The Dariusleut Hutterites of western Canada have the highest incidence of maxillary lateral tooth agenesis found in 47% of this population.

Tooth Agenesis Can Increase Through Generations

Tooth agenesis is a familial trait. Hypodontia, small number and size of teeth, is determined by a dominant autosomal gene pattern with incomplete penetrance and variable expressivity. Children inherit tooth agenesis from less severely affected parents. Tooth agenesis increases in number and magnitude after the mating of affected subjects.

Son’s X-Ray

Hypodontia May Be Linked To Ectodermal Dysplasia

Several authors have suggested that hypodontia is “micro” form of ectodermal dysplasia. Besides aberrations in the permanent dentition, these patients also exhibit delayed tooth eruption, hair and nail dysgenesis, dry skin, bilateral congenital hip dislocation and an asthmatic condition.

Several genes have been found to be required for the development or teeth. In the most specific human molecular study Vastaridis, H. (1996) found that a point mutation of a G to C transversion in the MSX1 gene at nucleotide residue 2125 produces tooth agenesis.

The G to C transversion results in the substitution of a positively-charged arginine to a neutral proline at residue 31 of the MSX1 homeodomain. Arg31 is within helix II of the homeodomain located close to the backbone of the alpha strand of DNA, and is thought to specifically interact with DNA via a salt bridge to the G-5 phosphate group. Perhaps the ARG31Pro mutation similarly attenuates MSX1 interaction with target DNA.

Orthodontists Can Recognize And Treat This Condition

Orthodontist Ann Marie Gorczyca, DMD, MPH, MS spent four years in the UCSF Oral Biology PhD program. She is a member of the Angle Society of Orthodontists where she presented the paper: “Tooth Agenesis: A Molecular Genetic Model.”

Orthodontists should be encouraged to extensively inquire about the family history of individuals with dental anomalies. Orthodontists could play a crucial role in the diagnosis of underreported entities of ectodermal dysplasia by bringing attention to its oral manifestations. Patients with numerous missing teeth should be referred to an orthodontist and a dermatologist.