Why Aren’t My Childs baby teeth falling out?

baby teeth diagramParents often worry that something is wrong when a child’s baby teeth do not fall out as expected. Although there are some developmental issues which require professional attention, most of the time everything is just fine. What should parents expect when it comes to their children losing baby teeth?

Baby teeth serve several purposes besides chewing. Primary teeth give rise to the permanent teeth and preserve space for them until they are developed enough to come in. If the baby teeth come out too early, space can be lost causing crowding of the underlying permanent ones. At the other extreme, baby teeth that are not lost on time can force the permanent ones to come in the wrong positon creating a more difficult orthodontic condition.

The most common reasons for primary teeth to be lost early are decay, trauma, and crowding. If a tooth has to be pulled because of disease or is lost due to trauma, your dentist is usually already involved. If the teeth are crowded, your child may lose two primary teeth naturally to accommodate the eruption of a single larger permanent tooth. If baby teeth are lost prematurely, Dr. Feldhaus will determine if a space maintainer is needed.

There are several conditions which prevent the baby teeth from falling out on schedule. If the underlying teeth are crowded, they may not be able to push out the overlying baby teeth. Baby teeth with no underlying permanent replacements may be retained indefinitely. Extra teeth can block the normal eruption of the regular permanent ones. With a simple x-ray, Dr. Feldhaus can tell you if there really is a problem or if your child is just developing slowly.

The most common reason for parents’ concern however is just misunderstanding the normal sequence of tooth loss in their developing child. The first baby teeth are usually lost at about six years of age. Some children may lose theirs as early as five or as late as seven and neither variation is a problem. By age eight, the average child will have lost eight baby teeth; four front teeth on top and four front teeth on the bottom. Again, a variation of a year in either direction is nothing to worry about. Between the ages of eight and ten there is not much change in the number of teeth. In other words, it is normal for a child to lose eight teeth in a row and then stop for about two years! (It is during this two-year “break” that it is best to provide interceptive orthodontic treatment if it is needed.) Around ten years of age the remaining teeth begin to loosen and fall out. The average adolescent loses their last primary tooth before they are 13 years old. The 12-year-molars also make their appearance during that 12th year (hence the name).

Most questions about delayed tooth loss come during that two year span between eight and ten where no teeth are lost. Such inactivity is unexpected by parents but completely normal. There is no need to worry about delayed tooth loss unless 1) the retained primary teeth are causing problems for the incoming permanent ones, 2) the 12-year molars are already erupted, or 3) the delayed tooth loss will cause orthodontic treatment to be started at an awkward age (i.e. the junior and senior years of high school). An important service that Dr. Feldhaus can provide is monitoring the dental development of your child and counseling with you about the need to have primary teeth removed if that should be necessary.

Why does my child need teeth removed for braces?

teeth removal for braces
“I want a perfect smile, but I don’t want any teeth removed!” Is one of the most common statements. Why is it recommend that some patients have teeth removed but not others? Why are teeth sometimes extracted as part of having braces?

All of us have two sets of teeth, primary (baby) and permanent (adult). One of the first things your orthodontist will do at your initial consultation is take inventory of which teeth are in your mouth. Although everyone is different, baby teeth usually fall out by a certain age and in a certain order. They can create orthodontic problems if they fall out too early or too late. If they fall out too early, Dr. Feldhaus can help you devise a plan for maintaining the space until the permanent replacements come in. If they don’t fall out soon enough, they may create an orthodontic problem or signal that one already exists. Removing primary teeth is sometimes necessary for the normal eruption and development of the teeth that will come in later.

While most parents have no concerns regarding the removal of primary teeth, some do when the permanent ones are involved. There are a variety of reasons why permanent teeth may need to be removed for braces, but here there are three main ones:

The first is crowding. When the amount of space required to align the teeth is less than the space available, either the size of the arches must be increased or the number (or size) of teeth reduced. Mild to moderate crowding can be addressed with expanders and braces alone up until about age 15. The amount of expansion may be limited by the bone structure, the facial appearance, or the supporting tissues. If a patient has moderate to severe crowding and insufficient gums or bone, permanent teeth will need to be removed to provide the necessary room.

The second reason is protrusion. The position of the lips is determined by the underlying teeth. If the front teeth are already protrusive, removing some on the sides will allow the orthodontist to move the teeth backwards to improve the lip posture. If the lips are in good position already but the underlying teeth are crooked, removing teeth may be necessary to prevent making the teeth and lips stick out.

The third reason is to correct an overbite or under bite. If the upper an lower jaw sizes are mismatched, the ideal treatment is to surgically reposition them. In most patients however, the jaw size discrepancy is small enough that the teeth can be moved to “compensate” for the problem. This eliminates the need for jaw surgery in the majority of overbite patients and some under bite patients. A patient with a moderate overbite is usually receptive to the idea of having two upper bicuspids removed if it prevents the need for surgery.

There are a variety of other reasons teeth may be removed as part of your treatment. These include asymmetries and missing, impacted, or extra teeth.

Why does my child need a retainer?

Retainer, childrens orthodonticsYour child needs a retainer for several reasons. The most common reason is to help their teeth stay set in their new positions after wearing braces. It’s important for them to wear their retainer because as their body grows, their teeth do some shifting. The retainer helps to control this shifting, which occurs naturally.

After your child’s braces are removed, Dr. Feldhaus takes an impression for a custom retainer. The patient gets to pick their own color and design for their retainer. The patient is instructed and expected to wear the retainer 24/7 for the first full year. Dr. Feldhaus also expects the post orthodontic patient to sleep in the retainer for the next few years. The retainer keeps the teeth in line and patients shouldn’t even notice it while you’re sleeping! A permanent wire is also bonded to the back of the lower permanent incisors. This will be there for several years as well to retain the normal position of the teeth.

Retainers can help many mouth problems besides shifting teeth. Sometimes they’re used to help a medical problem. For example, you may have a tongue thrust (a condition where your tongue sneaks through your teeth when you talk). Some retainers, known as a crib or tongue cage retainers, are designed with small metal bars that hang down from the roof of your mouth. These retainers keep your tongue from going forward in between your teeth when you speak. Your tongue is trained to go to the roof of your mouth instead of through your teeth. The length of time kids wear a tongue cage varies depending on the kid.

What are the benefits of having straight teeth?

Stragith teeth from braces
There are a number of us who want straight teeth because it gives us the advantage of looking better, appearance wise. However, aside from aesthetic justifications, having straight teeth can certainly affect several parts of our lives.
Dentists want to present patients the opportunity to experience life to the fullest. Principally, straight teeth are easier to keep clean than malaligned ones. Crooked teeth can also be the primary source of decay and other gum problems.

Most people take their straight teeth for granted. For persons with teeth irregularities, however, the simple act of eating becomes complete misery; diseases of the periodontal tissues that cause the teeth at the rear of the mouth to loosen can make it very unbearable for the individual to chew his or her food properly. The person cannot enjoy hard foodstuff like fruits, vegetables, and meat. In such a situation, it will always be hard to have a balanced diet. Having straight teeth and good dental hygiene can help one avoid woes that are related to crooked teeth.

The goal of Dr. Feldhaus is to create a natural looking, beautiful smile that people are quick to flash! A person with straight teeth has a much higher self-esteem than one that does not have straight teeth. Dr. Feldhaus wants his patients to have a smile that they are proud of.

How long do children need to wear braces?

childrens braces, kids braces
The length of time you will have to wear your braces is going to have a lot to do with your circumstances. Usually braces get worn anywhere from eighteen months to two full years. For some, they have to stay on even longer. Retainers are required in addition to the fixed orthodontic treatment.

The length of time that treatment lasts is determined by the difficulty of the case. For example, if a person has impacted canines, they may need to wear the braces longer to enable the teeth to be pulled down into the mouth.

The good news is that you have a little bit of a say in how long your braces and other orthodontic treatments remain on. As simple and silly as it might sound, dental hygiene plays a serious role in your orthodontic treatments and their effectiveness. Also, it is important that a patient is compliant with instructions given. If he is asked to wear rubber bands, then he needs to do that to shorten the time in orthodontics. It is also very important to not break the brackets and wires in between visits. It is also extremely imperative that people come in for their monthly othodontic appointments to stay on schedule with treatment.and have the braces on for a minimum amount of time.

Studies have proven that the earlier a person gets his braces put on, the faster the process will be. Most people don’t actually become proper candidates for the devices until they’re between the ages of ten and twelve but you can start being treated by Dr. Feldhaus as early as the age of seven. Lots of preparation goes into getting a young patient’s mouth ready to wear braces. Some of that work reduces the amount of time the braces will need to stay on the teeth.

What age should my child be evaluated for braces or orthodontics?

Childrens braces, pediatric braces, kids bracesThe American Association of Orthodontists recommends that most children should have an orthodontic screening by age 7. This allows Dr. Feldhaus to determine if orthodontic treatment will be required and the best time for the patient to be treated. Dr. Feldhaus has been trained to identify orthodontic problems early, and may recommend orthodontic treatment earlier than age 7.

If early treatment is indicated, Dr. Feldhaus can guide the growth of the jaw and incoming permanent teeth. Early treatment can also regulate the width of the upper and lower dental arches, gain space for permanent teeth, avoid the need for permanent tooth extractions, reduce the likelihood of impacted permanent teeth, correct thumb sucking, and eliminate abnormal swallowing or speech problems. In other words, early treatment can simplify later treatment, after all the permanent teeth erupt.

Early treatment does not necessarily benefit all children. Certain types of orthodontic problems can be more easily and efficiently corrected in the teen years when all the permanent teeth have erupted. Some skeletal orthodontic problems should not be addressed until growth is more advanced or completed. Dr. Feldhaus develops a plan for treatment based on each individual child’s needs. If the doctor decides the patient is not ready for treatment, they are placed on our orthodontic observation program.

Early treatment can begin the correction of significant problems, prevent more severe problems from developing, and simplify future orthodontic treatment. An example of early orthodontic treatment needed would be if a patient has a crossbite. A crossbite is described as a situation where the upper teeth are behind or on the tongue side of the bottom teeth when the patient bites down. This needs to be corrected because it prevents the upper jaw from growing properly. An appliance or intermediate braces are placed on the teeth for 6-12 months to move the upper teeth to the outside of the lower teeth in a normal occlusion. Because all of the permanent teeth have not yet erupted when early treatment is performed, their final alignment may not have been corrected. Typically, a shortened comprehensive phase of treatment in the teen years, after all the permanent teeth have erupted, completes the correction. However, in some circumstances, further orthodontic treatment may not be indicated.