Abnormal Eruption of Teeth: Definition, Causes, and Treatment
Orthodontic problems can happen to anyone – whether you are a child, an adolescent, or an adult. It even occurs to those who wore braces at an early age. The reason behind it is quite simple. Teeth are quite mobile, perhaps even more than you think.
In fact, teeth move almost every day in response to the activities that you do, such as eating, chewing gum or hard candies, and teeth grinding while sleeping. The movements are, of course, gradual, which is why you do not notice them.
However, it is possible for them to be pushed out of alignment. For example, children can develop habits that result in orthodontic problems. Some unhealthy habits are thumb sucking, clenching teeth, and tongue thrusting. Improper or the lack of brushing teeth will also lead to issues.
But many parents do not find these habits worrisome; until permanent teeth have started coming in. They usually appear at the age of seven, which is why a visit to the orthodontist is recommended at this time.
It’s good to know that teeth issues can be fixed no matter what your age may be. As long as your teeth and gums are healthy, you can get the smile you desire with the help of your orthodontist.
One common problem with teeth is an abnormal eruption, which happens when a tooth emerges at the wrong place.
What is an Abnormal Tooth Eruption?
Humans have two sets of teeth. The first one is the primary dentition, which comprises the teeth you developed when you were still young. When they fall out, and you grow new teeth, it is what is known as permanent dentition.
The primary dentition is typically made of 20 teeth, which start to erupt around the age of six months. Meanwhile, permanent teeth begin appearing at six years old until 32 teeth are completed.
The eruption has a specific sequence, which is usually symmetrical. It means that the tooth on the other side should erupt within six months after the other.
However, there can be eruption issues, including abnormal eruption. It is also known as ectopic eruption or ectopia, which pertains to a permanent tooth appearing or erupting where it should not. Impaction can take place where the tooth is blocked, preventing it from growing completely. Such a case often calls for a surgical procedure to uncover the tooth. It is often required before starting any orthodontic treatment.
Abnormal eruption is considered a disturbance in the development of the tooth, causing the tooth to erupt out of its normal position. With the eruption pathway altered, it should be fixed right away. Otherwise, it can create problems for your adjacent teeth.
How Does Eruption Happen?
As mentioned, teeth will begin to erupt around six months. By the time the child is three years old, all primary teeth are in place. You will find there are 10 upper teeth and another 10 below. When the kid reaches six or seven, these teeth will begin falling out and will be replaced by what people call “adult” or “permanent” teeth.
When the primary and permanent dentition both appear in the mouth, it is a stage known as mixed dentition. Permanent dentition lasts for the rest of your life or until you lose all your teeth, which is called edentulism. Not everyone will lose their teeth. The main reasons why your permanent teeth fall out are tooth decay and periodontal disease.
There will also be extra molars during that period, as well as around 12 and 18 years. The last molars are known as wisdom teeth, but not everyone has them. All in all, you will have 32 teeth when you reach adulthood.
Why Does Abnormal Eruption Happen?
Abnormal eruption is quite common because it affects a large percentage of the population. It typically happens in the maxilla, taking place unilaterally more often than not. The most common ectopic teeth are the following:
- Maxillary canines, pertaining to the teeth that are away from the centre of the face
- Maxillary first molars, which are those that are also away from the midline of your face and are the largest and strongest type of maxillary teeth
- Mandibular second premolars, which are primarily used for chewing
- Mandibular canines considered the cornerstone of the mouth or dental arches because of their location, which is three teeth away from the midline
An abnormal eruption can be caused by different factors. One of the most common causes is when a primary tooth falls out too early. During that time, the other teeth are unprepared, which lead to them drifting and changing positions. It is a subtle change, but you will see the effect with the spacing in the mouth, which results in abnormal eruption.
But losing a tooth too early is not the only problem. If you lose your teeth too late, it can also lead to an improper eruption. It is often due to the blockage caused by the baby teeth, and therefore the permanent tooth cannot grow correctly.
There are other causes of abnormal eruption, including the following:
- Hyperdontia: This condition is when you have more than 32 permanent teeth. There will no longer be enough space for the developing tooth, so it will grow in a place where it should not.
- More or Fewer Primary Teeth than Normal: If the child has fewer or more than 20 teeth, there is a huge possibility that abnormal eruption can occur once the teeth start to fall out. It happens because the spacing in the mouth is incorrect, to begin with.
- Injury: Those who have had a mouth or jaw injury are at risk of abnormal eruption.
- Small Jaw or Mouth: If your mouth does not provide ample space for all your teeth, at least one of your growing teeth will appear in the wrong place.
If the abnormal eruption involves the permanent first molars, it typically starts when primary teeth begin to fall out early in which the permanent first molar appears toward the primary second molar. It causes the eruption to stop, which leads to atypical resorption of the primary molar next to it.
The permanent tooth that grew incorrectly can get locked when it is held in this position. However, there are also cases when it corrects itself without the need for treatment.
There are a few factors that are believed to contribute to this teeth anomaly, such as:
- The molars, either primary or permanent, are quite large. In such a case, there is usually not enough room for the tooth to grow.
- The child has a missing second premolar, which leads to improper alignment of the teeth. As a result, once the primary teeth fall out, the permanent teeth will not be in the correct position.
- The permanent first molar did not develop at the right time.
How Can You Fix an Abnormal Tooth Eruption?
The solution to the abnormal tooth will depend on what tooth it is. However, early detection can help with proper intervention. It is why regular visits to the dentist are a must even at a young age.
Delayed correction typically happens, but it can have inevitable consequences. Some problems that may arise if an abnormal eruption is left alone include the premature loss of the second molar (primary, abscess formation, and pulpal infection.
You need to see an orthodontist who will help you identify whether you or your child has an abnormal eruption. Only an orthodontist can tell you how to approach the situation. A thorough exam will be performed to come up with a plan that will treat the problem. This plan involves looking at the position of the tooth, its location, and why it is not growing correctly. Usually, it means that something is blocking its way if it is not erupting entirely.
Traditionally, three strategies work to treat abnormal tooth eruption:
1. Observation and Analysis
The orthodontist will first wait about three to six months before doing anything. There have been many cases where the abnormal eruption does not require any treatment at all. It simply fixed itself on its own.
If the abnormal eruption involves the permanent first molar, it should move less than two millimetres toward the primary second molar. The length of the permanent molar should also show that tipping is almost non-existent. The orthodontist, at this point, may simply observe and wait for the tooth to erupt.
However, there are cases when a small amount of movement is required. Usually, the molar remains invisible. It may be possible that a procedure will be performed, such as placing a brass wire around the contact point between the primary and permanent molar. This wire will be tightened regularly, typically every two weeks to force the molar to move past the primary tooth.
The goal of the observation or evaluation period is to move the erupting tooth away from the adjacent tooth it may be resorbing. The orthodontist may allow this tooth to erupt and will keep the second molar (primary).
The second strategy is to extract the primary molar. This option is often chosen if the patient complains about pain. Mobility, meaning the tooth is moving, may be a problem. If the tooth moves but remains attached, it may have to be removed. It will then be followed by the next approach below.
The third option is an orthodontic procedure in which the molar teeth are moved backwards in an arch. Distalization is often used to treat patients with low to moderate malocclusion.
Examples of Appropriate Treatments
In children, if the baby tooth is coming loose but does not fall out, it may be extracted. This way, there will be correct spacing between the new teeth that will soon erupt.
Some teeth can go off course, straying away from their correct locations. The child can have an early orthodontic treatment to stop more significant problems from occurring.
Parents do not have to worry because the intervention is quite straightforward and gentle. A passive appliance may be used to correct the issue. This device will make sure there is space in the arch so the tooth can complete its eruption.
Some adults will need braces. The good news is that braces are nothing to be scared of. Technology has helped improve braces, especially for adults who do not want to wear metal in their mouth.
The options you have include clear aligners and ceramic. With ceramic braces, you have an appliance that can help fix your teeth without being too obvious. It is because the material takes on the natural colour of your teeth.
As mentioned, the treatment will vary depending on the affected tooth. If it is the first permanent molar, it means the erupting tooth is inclined into the second molar. The eruption may stop or be delayed, which is why the treatment will consist of the following processes:
- Contouring the back of the second primary molar
- Placing brass ligature wires, orthodontic appliance, or separating elastics for distalising the first molar
- Removing or extraction of the second primary molar
If the second primary molar is removed, a distalising appliance will be placed.
We Can Help
The orthodontists at Kingsley Orthodontics will take care of you and your teeth. Whether you or your child requires orthodontic intervention because of abnormal eruption, we will help you achieve the smile you want.
You can rest assured that orthodontics can help fix your teeth issue even when you are older. If the eruption resulted in misalignment or other bite problems, you need braces to correct the teeth.
Schedule an appointment with us, and we will figure out the best course of treatment on consultation. Kingsley Orthodontics offers fixed appliances, such as metal braces for adults. If you want a more discreet option, we can guide you if your case qualifies for an Invisalign treatment or incognito braces.
For more information, give us a call, and our friendly staff will gladly assist you.