upper incisor missing, 28 months old

[sunshines76]

I have posted a pic of my daughter's upper jaw. She has almost all baby teeth come in by now (she is 28 months old), but it looks like one of her upper lateral incisors is missing. It looks like a central incisor on that side took its space not letting the tooth coming. There is a big gap between her two upper central incisors, which probably contributed to the problem. I am taking her to the dentist next week. Meanwhile I need some advice as to which questions to ask the doctor, what could be the options, etc. I hope the tooth is till there, just didn't come in. Or could it be that she never developed that tooth at all?

[Jerome Tsang, DDS]

Yes.  Just because she's missing her baby incisor does not mean she'll be missing her adult one.  I would wait until she's old enough for x-rays.  There isn't much the dentist can do in the meantime and even if she is missing a tooth, there's not much that can be done to regenerate or grow it back.  It would need to be addressed as she grows up and when she's finally done growing (at age 18 for girls) a dental implant can be done.  Again, I understand your concern but at this stage in her development, I would take a wait and see approach.

[sunshines76]

Doctor, our dentist said that it was too early to make an X-ray. What about an ultrasound? My daughter will be 2,5 in March - is it possible to use iltrasound to check if the tooth is there or missing?

Also, what I understood from our family dentist's explanation, is that the fact that she is missing her baby lateral incisor now doesn't always mean that she would be missing her adult lateral incisor later. Is this correct?

[Jerome Tsang, DDS]

Hi,

Ya, the tooth is probably longer because the adult tooth underneath had more time to resorb  the root and shorten the tooth so that it can be pushed out.  Due to the hard fall, it sounds like the tooth probably came out before it was intended to.  I would go to your dentist to get it checked out and make sure that all of the tooth is out and that there's nothing left in there that may get infected.  

[daliamare]

Hi
My son is 40 months old, he fell on a hard floor and lost his upper central tooth (left), it came out completely but strangley it was long, around 18mm.
My question is will this affect in anyway the permanent tooth growth? could there be anything attached to the missing tooth that belongs to the permanent tooth?
I am confused because my two older daughters had tiny teeths when they fell at age of 6 ( no more than 4mm deep)
Best Regards
Dalia

[Jerome Tsang, DDS]

Ya, thumb sucking at an older age can adversely affect her teeth.  Because of the powerful muscles in the mouth that are used to thumb suck, it can move her teeth to the wrong position.  Generally it results in an open bite in which the front teeth procline (stick out).  If her thumb sucking habit is an issue, they can put an appliance which can block her finger from going in.  Again, that's an issue down the road.  Until then, I would monitor it and hope she'll stop on her own, which most children do.

[sunshines76]

Thank you, Doctor Tsang. We just came back from our dentist. She suggested we should wait and see till she is 4. My daughter is also still likes to suck on her thumb, I guess we have to break that habbit sooner.

[Jerome Tsang, DDS]

There is definitely a missing lateral incisor in the picture as far as I can tell. If possible, an x-ray may need to be taken to see if the missing incisor is present.  If its missing, there isn't any real treatment for the missing tooth as long as the permanent tooth is present.  If an x-ray isn't present, I would think the dentist would just observe the condition and see if it may erupt at a later time.  They may also decide to take x-rays when she's older.