Why Do I Still Have Baby Teeth?

Have you ever heard of an adult with baby teeth? You may be wondering, “how is this possible?” It is actually moMost adults with a baby tooth still in place have it for one reason: the permanent tooth underneath never formed. With no replacement pushing up from below, the primary tooth is never shed and can stay put for decades. Dentists call this a retained primary tooth, and the missing permanent tooth is called congenitally missing, or hypodontia. It is more common than most people expect, and the usual sites are the upper lateral incisors, the second premolars and the wisdom teeth.

A retained baby tooth is not an emergency, and some last well into adulthood. The question is how long yours will last, and what the plan is for the space when it eventually goes.

Why A Baby Tooth Stays In An Adult Mouth

• The permanent tooth never developed. This is by far the most common cause. Congenitally missing teeth often run in families.
• The permanent tooth is impacted. It formed but is stuck in the bone and cannot erupt, often because it is angled wrongly or blocked by crowding. Upper canines are the classic example.
• Ankylosis. The baby tooth has fused to the jawbone, so it cannot be pushed out. An ankylosed tooth often sits lower than its neighbors, as if it is sinking.
• Not enough room. Crowding can stop the permanent tooth from coming through even when it exists.
• Extra teeth or a cyst blocking the eruption path.

An x-ray answers the question quickly. It shows whether a permanent tooth is waiting underneath, stuck somewhere else, or absent altogether, and that is what decides the treatment.

Is It A Problem To Keep A Baby Tooth?

Sometimes it is fine for years. A retained primary tooth with a healthy root, no decay and a reasonable position can be kept and monitored. But baby teeth were built for a shorter service life, and several things tend to catch up with them:

• Smaller and thinner. The enamel is thinner than on a permanent tooth, so decay and wear progress faster.
• Shorter roots. Roots can resorb over time, and the tooth gradually loosens.
• They sit lower. A baby tooth is smaller than the permanent tooth it replaced, so the bite is often uneven and the neighboring teeth can tip toward it.
• Appearance. In the front of the mouth, a smaller, differently shaped tooth can stand out, especially where the color no longer matches.
• Ankylosis. A fused tooth stops moving while the rest of the jaw continues developing, which can leave it below the bite line and create a step in the gumline.

What Happens When The Baby Tooth Is Lost

Once it comes out, you have a gap with no natural replacement, and the jawbone at that site starts to resorb like any other extraction site. Neighboring teeth can drift, and the opposing tooth can over-erupt into the space. The bone under a long-retained baby tooth is also often narrower than usual, because a small primary root does not maintain a full-width ridge.

That is why the plan matters before the tooth fails, not after. Our page on the consequences of single tooth loss explains what happens to an untreated space.

Treatment Options For Adults With Baby Teeth

• Keep and monitor. If the tooth is sound and the bite works, the sensible option is often to leave it and check it at regular visits.
• Restore it. Bonding or a crown can improve the shape, color and height of a retained tooth and keep it in service longer.
• Orthodontics. If a permanent tooth is impacted, an orthodontist may be able to bring it into position. Alternatively, braces or aligners can close the space or open it to the right width for a replacement tooth.
• Extraction and a dental implant. The most common definitive plan for a congenitally missing tooth. The implant replaces the root as well as the crown and preserves the bone at that site.
• A bridge. A bonded (Maryland) bridge is a conservative option for a front tooth, and a conventional bridge is an alternative where the neighboring teeth already need crowns.

Where several teeth are congenitally missing, see our page on congenitally missing teeth.

Timing Matters, Especially For Implants

An implant cannot be placed until the jaw has finished growing, which is usually the late teens or early twenties, and later in some men. Placing one too early leaves it out of line as the rest of the face develops. For younger patients the usual approach is to keep the baby tooth or use a temporary replacement until growth is complete.

For adults, the sequence is planning first: a cone beam CT scan shows how much bone is at the site, whether the width is enough for an implant, and whether socket preservation at the time of extraction or ridge augmentation will be needed. In some cases the implant can be placed on the same day the baby tooth is removed.

Frequently Asked Questions

Is It Normal For An Adult To Have A Baby Tooth?

It is not unusual. Retained primary teeth are most often seen where a permanent tooth is congenitally missing, which is one of the more common dental developmental differences.

Should A Retained Baby Tooth Be Pulled?

Not automatically. If it is healthy, well positioned and not causing bite problems, keeping it is often the better choice. It is usually removed when it becomes loose, decayed, worn down or badly out of line.

How Long Can A Baby Tooth Last In An Adult?

That varies. Some last into a person’s forties or beyond, particularly where the root has not resorbed. Others fail much sooner. Regular x-rays show how the root is holding up.

Can I Get An Implant Where My Baby Tooth Was?

In most cases, yes, once the jaw has stopped growing. The site may need grafting first if the ridge is narrow, which is common where a small primary root has been holding the space.

Why Did My Permanent Tooth Never Come In?

Usually because it never formed, which is often inherited. Sometimes it did form but is impacted in the bone. An x-ray tells you which.

Book A Consultation

If you still have a baby tooth and want to know how long it is likely to last, our board-certified periodontists can assess the tooth, the bone beneath it and your options for replacing it when the time comes. Call (347) 493-2439 or request a consultation online.