Thursday, September 13, 2012

Gap Between the Upper and Lower Back Teeth Because the Baby Teeth Stop Erupting While the Face Grows

When a single baby molar appears submerged relative to its neighbors, or when the baby back teeth do not chew against the opposing teeth but are in openbite, you might suspect either that the baby tooth root has frozen to the bone, or else there may be an absent bicuspid underneath.  An x-ray will ascertain if it is a missing permanent tooth,

If a missing permanent tooth is overlooked in the absence of an x-ray, it might be a big mistake to extract the submerged baby tooth, because the resulting space might require a bridge or an implant, or braces to close the space.

On the other hand, if the submerged baby molar is saved into adulthood, and has not submerged too severely, it may recieve a restoration to raise it up to the level of the chewing plane, and be useful for many years.  However, a baby molar that "submerges" early may be too deeply sunken by the relative eruption of the adjacent permanent teeth, to be restorable, and may create such an uncleanable gumline environment for its neighbors that extraction is its eventual best fate.

Since early discovery of a submerged baby molar sometimes means a poor future for that tooth, it is best to involve an orthodontist early in that situation, so that extraction and space closure can be considered.  Another occasional cause of a posterior openbite is a later tongue thrust, where the tongue bulges out sideways and creates a gap between the upper and lower back teeth.  This can be treated with a screen appliance by an orthodontist, and speech therapy to retrain the tongue.