What is edentia and the dangers of missing teeth?

Timing of teething

The wait is especially long after the removal of chewing temporary teeth, which are usually the first to suffer from caries and its complications. Often, parents frivolously insist on removing molar baby teeth, blithely declaring: permanent ones will grow in!

But the process of changing bites develops according to strict laws. Follicles (buds) of temporary and permanent teeth are located in two rows in each jaw of a newborn, going through successive stages of formation and mineralization before eruption. It is impossible to speed up these stages by any means.

The milky roots gradually dissolve, and permanent follicles are pushed out in their place by the coronal part. And only after the formation is completed, permanent teeth appear above the surface of the gum. The first to erupt is the so-called “sixth tooth” - the first molar, which parents often mistake for temporary, and therefore do not treat its carious lesions. This tooth has an important function - it determines the height of the permanent bite and the place of the other “brothers” in the dentition.

We give approximate dates for the appearance of permanent teeth to make it easier for parents to navigate the normality of the change process:

• first incisor - 6-7 years;
• second incisor - 7-8 years;
• fang - 9-11 years;
• first small root - 8-10 years;
• second small root - 11-12 years;
• first major molar - 6 years;
• second major molar - 13-14 years.

Small molars replace primary chewing teeth. If a temporary tooth was removed at the age of 6-7 years, which is not uncommon, then the child is deprived of the ability to fully chew food for as long as 5-6 years. Therefore, it is so important to promptly treat caries of milk precursors.

What causes delayed teething in children?

It must be said that there are many reasons for the delay in the appearance of baby teeth, and most often harmless factors are found. At the same time, the dentist recommends simple stimulation of teething (massage of the gums, use of special gels), and soon the long-awaited teeth take their places.

The reasons for late teething in children include:

• Hereditary factor
• Insufficient amount of useful elements (vitamin D, calcium). In this sense, infants are at risk because artificial formulas contain more minerals that promote the growth and development of teeth
• Congenital pathologies (the presence of supernumerary teeth that interfere with the eruption of the rest, tumors of various natures, regional odontodysplasia, a genetic disorder in the development of the jaws, cleft palate, cleft lip, etc.)
• Bruises, injuries, consequences of previous diseases
• Pathologies of the endocrine system (impaired hormone secretion)
• Prematurity (babies born prematurely develop more slowly than their peers)
• Past diseases and disorders during intrauterine development (lack of nutrients, poor maternal lifestyle), complicated pregnancy
• Congenital rickets
• Anemia
• Ichthyosis
• HIV infection
• Long-term chemotherapy or anticonvulsants
• Genetic abnormalities: Gardner syndrome, Down syndrome
• Delayed physical and mental development

If some of the above causes are diagnosed (for example, rickets), a cure, unfortunately, is impossible.

However, the vast majority of clinical cases are nothing more than parents’ vain worries. Most often it turns out that delayed teething is not a pathology, but a developmental feature.

Consequences of early destruction of primary teeth

After the early removal of a baby tooth, the gum in its place becomes overgrown, and the permanent one is deprived of its natural landmark. This leads to phenomena such as:

• dystopia - eruption of a permanent tooth outside the dental arch;
• retention - the occurrence of a formed tooth in the thickness of the jaw bone.

If the baby tooth does not receive treatment, and the inflammatory process spreads to its roots, then the permanent follicle located under them is damaged. In this case, the permanent one may die, and then its place in the dentition will remain empty. The absence of a tooth is confirmed by radiography.

What types of delayed eruption are there?

Currently, doctors talk about two main types of delayed eruption.

The first is retention. Pathology is diagnosed in 1-7% of cases, and retention can be associated with both baby teeth and permanent teeth. The essence of the disorder is that the teeth have already formed, but have not yet erupted. The pathology can be caused by various anomalies: improper formation of buds, inflammatory processes, hematomas. In many children, the canines of the upper jaw are susceptible to retention.

The causes of adentia are not fully understood

The second type is edentulous. This is a more dangerous pathology in which the absence of teeth (complete or partial) is detected. The absence of all teeth is extremely rare, and the reasons for such an anomaly are not fully understood. Usually we are talking about problems with the formation of tooth germs in the prenatal period, and this, in turn, is provoked by various external factors (infections and inflammations, poor lifestyle of the mother, complicated pregnancy, deficiency of nutrients). In case of edentia, an x-ray is prescribed, during which it is determined whether there are any rudiments of milk teeth in the jaw. If they are present, the reason why teeth are not erupting is determined.

Problems when changing bites

Sometimes a situation arises that a child “grows a tooth under a tooth” - the permanent one has already appeared above the gum, and the temporary one is firmly held in its place. This happens when the resorption process of one or more milky roots is disrupted. This is also a reason to contact pediatric dentistry - after all, no one can say in how many days a loose baby tooth will fall out, and its “stubbornness” leads to the dystopia of a permanent one.

Dental doctors remove even such semi-loose teeth with anesthesia, so as not to cause discomfort to children. Only a specialist can decide what to do when changing the bite. Regular monitoring by the dentist during such an important period will help to avoid the formation of an abnormal relationship of the dentition, which will require further treatment by an orthodontist.

If a child’s baby tooth is loose, then you shouldn’t guess how long it will take for it to fall out; it’s better to consult a doctor without delay for qualified advice.

At the Shifa clinic, children are treated with modern equipment using the latest materials. The center has all the conditions for an accurate diagnosis of the condition of primary and permanent dentition, and this is the key to correct medical tactics. The dentists of the Shifa clinic find an approach to every child and master the most advanced methods of assistance, constantly improving their professionalism in Russia and abroad. Contact the best doctors who will help solve any dental problem!

What determines the timing of teeth appearance?

A deviation in the timing of the appearance of a baby’s first teeth from one to two months is considered normal.

Dentists believe that the appearance of teeth 1-2 months earlier or later than normal is acceptable. So, some babies have their first teeth as early as 4 months, and some don’t even have them at 11. This is dictated by the individual developmental characteristics of the baby, but it is still possible to determine the factors that influence the timing of the appearance of teeth:

• Type of feeding. As already mentioned, breastfeeding is not always better than artificial feeding. Breast milk is not as rich in nutrients as artificial formulas, so infants start teething more often
• Climatic conditions. There is an interesting pattern here: the hotter the climate, the earlier teeth appear
• Hereditary characteristics. You shouldn’t wait for a child’s first teeth at 5-6 months if the parents only got them at 9 months.
• Quality of drinking water and compliance with drinking regime
• Proper child care

So in some cases, parents' concerns are unfounded.

If the tooth has not grown, we will pull it out

IF THE TOOTH HAS NOT GROWN, WE WILL PULL IT OUT

An orthodontist is a doctor who is especially popular today not only among children, but also among adults. It is relatively easy for children to straighten their teeth while the jaw bones are still young and pliable. But in adults, bite treatment is no longer a problem. Most often, orthodontic treatment is required when a person decides to undergo prosthetics. He comes, as expected, to the orthopedist, and he is immediately referred to the orthodontist. There are several reasons for this,” says medical orthodontist Roman Labzin.

One of the reasons is that there is not enough space in the mouth for dentures, which means that the dentition needs to be moved apart. Crowded teeth also require correction of their position. In general, an orthodontist is the first doctor who prepares the mouth for prosthetics.

Or could it happen that after visiting the orthodontist, you won’t need prosthetics? Will all teeth fall into place or will they successfully take someone else’s teeth?

Through orthodontic treatment, it is actually possible to replace missing teeth and do without prosthetics. For example, a patient once had his lower sixth teeth removed. He is faced with a choice - either to install an implant at great expense and cover it with a crown, or... to move nearby teeth. Typically, such people have problems with their bite and teeth alignment. By correcting the bite, I can close the gap of the extracted tooth - that is, kill two birds with one stone.

Some kind of “epidemic” has begun with malocclusions - you walk around the city and see almost every second person has braces on their teeth, and, surprisingly, in adults.

And this is not surprising. It is adults who most often turn to the orthodontist due to malocclusion. This problem actually occurs in every second person. The bad habits that adults instill in children, starting from infancy, play a detrimental role in this. For example, the habit of using a pacifier. I had a girl who did not take the pacifier out of her mouth until she was six years old. And as they get older, children begin to eat incorrectly—swallowing food, chewing it poorly. Apparently, looking at adults who are always in a hurry somewhere. Due to products that are already sold in a “chewed” state - yoghurts, muesli, baby purees, children and teenagers no longer need to chew, therefore teeth do not grow, jaws do not change and an anomaly is formed. Add here pathologies from the nasal cavity - adenoids, which in our humid climate develop in almost all children, and you get another reason for improper development of the jaw.

How exactly do adenoids affect teeth?

Due to adenoids, nasal breathing is impaired, and the child constantly breathes through the mouth. His lower jaw droops, and his upper jaw becomes very narrow, so there is not enough space for all his teeth, and they grow, overlapping each other. There are many reasons for the development of malocclusion. The most important function of teeth is chewing, so chewing is essential for both children and adults.

And if an adult has nothing to chew, is it not harmful for him to go without teeth for years?

Of course, it is harmful, now for the gastrointestinal tract, since undigested food causes gastritis and ulcers. In addition, ten years after losing teeth, such deformations will occur in the oral cavity that it will be very difficult to restore a normal bite. Rational prosthetics must be done on time.

How long after root removal do I have to wait before getting prosthetics?

It is better to do this within six months, or at most, up to a year.

How does your bite change with age?

First of all, the depth of the bite changes. While eating, the teeth rub against each other and gradually wear down and decrease in height. Such physiological wear of teeth over the years can significantly shorten them and lead to periodontitis. When this process occurs too quickly, pathological tooth wear develops, which causes a deep bite. A deep bite is a jaw condition in which the upper teeth overlap the lower teeth by more than one-third of the incisor crowns.

So, you should nibble on carrots while you’re young, and switch to more gentle food as you get older?

Of course, after 50 years it is better to take care of your teeth. Moreover, if the teeth wear evenly, the orthodontist will not help. Then it is better to contact an orthopedist, who can prevent further tooth wear by placing crowns on them.

What other bite pathologies are there?

Medial bite – when the lower jaw protrudes and the lower teeth protrude above the upper teeth. This pathology does not give a very aesthetic appearance to the face, but it is most often congenital and genetically inherited. Orthodontic treatment will not help here; maxillofacial surgery is necessary.

Changing the bite does not have a very good effect on appearance...

Yes, a decrease in bite height due to tooth wear leads to a visual reduction in the lower third of the face and a deepening of the nasolabial fold. Of course, this ages the face. Therefore, dental prosthetics and, accordingly, orthodontic treatment should be carried out in due time.

Until what age can a bite be cured?

One client I gave braces to was 58 years old. She had an impacted canine - a tooth that had formed at one time, but never erupted. Many years ago, the dentist apparently did not notice it, and when her baby tooth fell out, he gave her a denture, which she wore all her life. And we carried out orthodontic treatment and pulled this canine out. Now she has her own real tooth.

How often do such situations occur?

I have several patients with impacted fangs, some have one tooth left in the bone, others have both. Quite often the upper incisors fail to grow in, this happens for various reasons. One of the most common is the removal of baby teeth in early childhood. It very rarely happens the other way around. Milk teeth are retained until a person is 25 years of age or older. And the permanent tooth not only does not grow, but is completely absent from the bone. Then you have to place an implant and also carry out orthodontic treatment. Braces are the most popular type of correction among people. And when they do not help, then you have to resort to other structures, including removable ones. There are many treatment methods, of which I choose only those that are suitable for a particular person with his bite and problems.

What are the main indications for treatment by an orthodontist?

The main indication is teeth that are incorrectly positioned or grown in the wrong place. Of course, a greatly altered bite, which we have already talked about. Small changes in the bite are difficult for a person to determine on their own, so it would not hurt for every person to come for a consultation with an orthopedist at least once.

You can go to the orthodontics section at the multidisciplinary clinic “Panorama Med” here .

To make an appointment with an orthodontist, call: +7 (812) 244-90-10 and 8 (812) 970-00-70

When do the first teeth usually appear?

At birth, a child's teeth are in a state of maturation within the jaw bones. There is a complete set of baby teeth in various stages of growth and hardening (mineralization). The front teeth form earlier than the others and begin to emerge into the oral cavity, cutting through the gums, already when the child reaches the age of six months. With the normal and correct development of a child, teeth continue to erupt on time and in pairs - one on each side, and a full set of twenty milk teeth appears by the age of three.

Teething symptoms

Why does bone tissue decrease when teeth are missing?

Very often, when planning dental restoration using implants, we are faced with a deficiency of bone tissue, which is accurately detected during computed tomography:

Let's figure out what it is and why it happens

Let's start with the fact that bone is a living tissue, with its own laws of life. In the case of implantation, we are talking about the alveolar bone, that is, the bone of the alveolar process - the bone where the roots of the teeth are located. And when we talk about bone deficiency, we are talking about a deficiency of the alveolar bone. This bone provides support and stability to teeth. Its entire structure is aimed at stabilization.

And when teeth are lost, the need for this bone disappears and its resorption or resorption occurs. Loss of alveolar bone can also occur with preserved teeth due to periodontitis. The loss of bone tissue increases many times over when using removable dentures, since the denture exerts unusual pressure on the gum and bone, pressure for which the bone was not “designed” to bear. As a result, we are faced with a situation where the bone - where the implants can be installed - is missing or insufficient.

An example of what can happen to the bone tissue of a patient who had a tooth removed more than 15 years ago and did not go to the doctor only because he was afraid of the sinus lift procedure is shown in detail in my article “He was afraid of the sinus lift and waited... 15 (!) years"

We will talk about methods of treating adentia in the next article.