How late is too late for teeth to fall out?
July 12, 2016 10:41 AM   Subscribe

I took my 14-year-old kid to the dentist for a check-up, and it turns out that her upper baby canines have never fallen out. Uh, now what?

The dentist did take an x-ray that showed the adult canines are up there, just kind of waiting in the wings. So they shrugged and told us to go to an... orthodontist? And maybe have her baby teeth removed?!

I am weirded out by all of this! Is this really a situation where intervention is needed, or could we give it another year and see if it resolves on its own? Is an orthodontist the right professional, or should we be looking for an oral surgeon instead? And is this going to be some kind of insurance nightmare or will it probably be OK with good-ish insurance?
posted by Andrhia to Health & Fitness (31 answers total) 2 users marked this as a favorite
Used to work for an oral surgeon. I'd check with the orthodontist first (since braces will almost definitely be needed eventually) but you'll probably need the oral surgeon to extract the baby teeth and expose the adult teeth enough to attach the bracket. Once they get pulled down far enough, the orthodontist may reposition the bracket. The orthodontist will know exactly what to do though.

If you have good *dental* insurance they should cover at least the extraction and anesthesia. YMMV; get the codes from the surgeon and then call insurance yourself.
posted by supercres at 10:45 AM on July 12, 2016

Go see the orthodontist. My sons were seeing one when they were in elementary school for related issues. The orthodontist will know what is the best course of action here.
posted by Michele in California at 10:46 AM on July 12, 2016

These are great questions for your dentist and/or hygienist. Or, get a second opinion from another dentist and don't leave until you get answers to aaaaallllll of your questions. Once you have more/better answers, you can talk to your insurance company and see what they say.

Don't panic! It's okay! When I went in to get braces at about the same age, my mother was told that my baby molars had never fallen out! So the dentist removed them and we waited a few months for my adult molars to grow in a bit so the braces could be started.

Also, my daughter had to have baby teeth removed but it's because they were fused to the bone and would never come out on their own. The orthodontist didn't do that one, it was an oral surgeon.
posted by cooker girl at 10:46 AM on July 12, 2016

(Should note: the surgical bracket attachment may not be strictly necessary, but it will mak things go quicker than waiting for the adult teeth to surface on their own.)
posted by supercres at 10:47 AM on July 12, 2016

I had like five baby teeth pulled for this reason, it was no big deal and my teeth all came in normally afterward.
posted by showbiz_liz at 10:50 AM on July 12, 2016 [5 favorites]

A similar thing occurred with a family member - they had one upper canine that stuck around forever, and X-rays showed the adult tooth just chilling up above it. I think they were about twelve? Braces-getting age. They had the baby tooth removed and wore a retainer to make room for the missing tooth and it came in like normal.

The reason I remember this is that my upper right canine never descended, though all my baby teeth fell out very early. So when my parents took me to an orthodontist upon recommendation of my dentist and the ortho started explaining what they were going to try to do, my mom chimed in with that story and how her own lower left canine never showed up, either. Guess shy canines run in the family.

Ask around for recommendations for an orthodontist, they can be sort of hit or miss, but they'll be the go-to for finding an oral surgeon and there will likely be some assistance needed for your kid's teeth to come in smoothly.
posted by Mizu at 10:51 AM on July 12, 2016

The orthodondist will give advice on whether or not the teeth need pulling vs. waiting, along with whether extraction should be fine for the dentist to do vs. the oral surgeon. I'm not aware of ortho's generally pulling teeth - ours will be doing some reshaping of teeth (one of our son's perm. teeth was never formed and he elected to try to make the teeth look more "normal"), but never pulled any teeth. Some teeth we've had pulled via dentist, some via oral surgeon, and some were just "let's give it at least another year."

If you're considering braces down the line, now would be a good time to start shopping for a good and affordable ortho. We've seen price quotes vary by more than $2k for the same proposed work.
posted by nobeagle at 10:54 AM on July 12, 2016

I'd consult an oral surgeon sooner than later. In our case, the adult molar didn't have room to develop properly behind the undescended baby molar and both had to be surgically extracted, followed by braces for alignment and the option of a) just having one fewer molar on that side, b) letting the wisdom tooth fill the gap later, or c) dental implant.
posted by Flannery Culp at 10:58 AM on July 12, 2016

Just an anecdote:

When I was 12 I had oral surgery to remove the adult canine (that was apparently never going to descend) from my upper gum.

My oral surgeon at the time remarked that my baby tooth would probably fall out within the next few years, but I'm 38 now and it's still hanging in there.
posted by bdk3clash at 11:05 AM on July 12, 2016

What problem is it causing that intervention is needed?

I had my baby canines pulled at 13 and my adult canines came in eventually, but my teeth shifted in the meantime and I needed more orthodontic work than I likely would have needed otherwise. I just had slow teeth. Didn't get my first tooth until I was over 1 year old, didn't start losing teeth until I was 8, didn't get my wisdom teeth until I was 23 -- all apparently within the range of "normal" but definitely in the slow end of normal.
posted by erst at 11:08 AM on July 12, 2016

I knew someone from Italy who was in her early 20s and still had two of her "deciduous" teeth. They were so tiny! Apparently the dentists didn't think it was a problem and she thought they were awesome.
posted by aniola at 11:12 AM on July 12, 2016

Response by poster: FWIW it's not causing any actual problem right now, just the possibility that something has gone horribly wrong or might cause a problem later? Her teeth right now look perfect. She's always been a slow teether, too, but she did lose her first tooth when she was 7.
posted by Andrhia at 11:14 AM on July 12, 2016

I know someone that had this. Eventually the offending tooth got pulled, and the new one arrived just fine.
posted by katrielalex at 11:17 AM on July 12, 2016

My baby teeth were slow to come out. I lost a canine tooth at 14. It was embarrassing, but I survived just fine. I'm 40 years old and still have a baby tooth. Teeth are weird.
posted by kamikazegopher at 11:23 AM on July 12, 2016 [1 favorite]

My mother had this, and her canine grew in crooked over the other teeth, but otherwise nothing happened.

I also have one impacted canine (like someone above thread said). It just hangs out up there. I didn't get braces because I was a stubborn kid and my parents figured it wasn't doing any harm.

Baby tooth is hanging in there at 28; my dentist makes sure to x-ray where the canine should be to make sure there's nothing weird happening, and I'm extra careful to brush and floss the tooth (because its roots aren't as deep, it's easier to screw up apparently). But I've had two dentists since we figured this out and both of them have basically said "well, that's weird, you can get it fixed if you want or just leave it for now" and I've decided to leave it.

I say this because I don't think you should freak out, but y'know, listen to the dentist and orthodontist.
posted by dismas at 11:26 AM on July 12, 2016

My upper left adult canine never descended and it and the baby tooth were removed when I was 17 as part of work done to correct an overcrowded jaw/skewed bite with braces. If I hadn't needed that work, my dentist and orthodontist both said it would have been fine in the long run, it just made sense to take them out at the time because of the other work. It's probably worth talking to an orthodontist but it probably isn't immediately a Thing.

(I will, however, make a crap vampire with only one fang but I'm not going to lose sleep over that tbh)
posted by halcyonday at 11:39 AM on July 12, 2016

Hello! Baby toothed person here!

A number of my "adult" teeth never came in. Didn't need braces, because my teeth fit in my mouth. Bigger ones would have jumbled.


Dentists scared the heck out of my mom (and later me) with dire predictions of crumbling by the time I was 20, etc.

I have had 2 implants in the past 2 years. My other teeth are fine. I'm 51.

By the time your kid needs them, stem cell teeth will be a thing. Baby teeth people rule.
posted by SockPuppetOfShame at 11:56 AM on July 12, 2016

Check with family members, teeth issues are usually genetic. You can find out what they did and view the results. I had a permanent tooth that never came in. I kept the baby tooth until I was nearly forty. I only had it removed because it had a cavity and I could afford the implant at that time. They can really hang in there.
posted by myselfasme at 12:07 PM on July 12, 2016

I've had 10 teeth pulled. 4 permanent (canines) and 6 baby teeth that wouldn't come out. My torture started in 6th grade with a palate expander and I got my braces off in my Junior year. I think my teeth were all pulled between 12 and 14. I think 4 of my adult teeth refused to come in and they were pulled down into place with the braces.

Oh, and then I had my wisdom teeth out at age 20.

Yes, you need to speak to an orthodontist next.
posted by humboldt32 at 12:07 PM on July 12, 2016

This was me! In my case, my adult teeth did come in, but some of my baby teeth did not take the hint and leave. And then the baby teeth FUSED with the adult teeth, so I had double decker fang things.

Anyway, I went to the dentist and they had to BREAK OFF THE BABY TEETH WITH WHAT WAS BASICALLY A WRENCH AND I COULD FEEL THE BREAKING THROUGHOUT MY ENTIRE SKULL, but it didn’t hurt and then my teeth were fine, so, no harm done after all.

So yeah, some baby teeth hang out too long. It’s weird.
posted by a fiendish thingy at 12:07 PM on July 12, 2016 [1 favorite]

My sister-in-law had a genetic thing with baby teeth not falling out. My nephew inherited it. He was x-rayed every year and his teeth were pulled as needed. It was weird but not dangerous.
posted by ficbot at 1:00 PM on July 12, 2016

Happened to me. One became a precancerous cyst and the other they managed to pull down using a gold chain they removed a link off every week for six weeks I think. The cyst surgery took seven hours and hurt a lot. So I would do something quickly.
posted by parmanparman at 1:32 PM on July 12, 2016

Yeah I had a bunch of baby teeth attached to my jawbone. They literally had to crack them out of my head, because they were never going to come out on their own. The first two were when I was 7 and I was numbed but awake. Worst experience of my (and my mother's) life. The next four were when I was older, and I was put under, and it was easy as pie. If this is your situation, definitely get them pulled, but definitely get them pulled *while totally drugged into oblivion*.
posted by olinerd at 2:30 PM on July 12, 2016

I had a bunch of baby teeth pulled when I was 14 because they weren't coming out (I'm pretty lazy and figured the teeth were too).

Only issue was my mother said the tooth fairy would find it expensive getting hit with all 7 teeth at once and I should dole them out over a few months.
posted by kitten magic at 3:38 PM on July 12, 2016 [2 favorites]

I had nearly all my baby teeth extracted over time beginning around 7 or 8 (the age is fuzzy but they were all gone by 12, I think) because the adult teeth were coming in and my baby teeth roots were just too damn strong. It's incredibly unpleasant, but it was necessary, and this is common enough not to be too concerned. Hopefully, the procedure is a bit easier now. If this is a trusted dentist, I'd take their advice and see an orthodontist. Good luck!
posted by katemcd at 4:47 PM on July 12, 2016

LIke others on this thread, I have a baby tooth (incisor) that never fell out. I'm decades past my baby tooth prime; it doesn't really show when I smile, and as I've gotten older, we've added a little enamel to keep it safe. This is quite common. My nephew lost his baby teeth in his 20s. My aunt had baby teeth into her 50s. A dentist in the South said he saw it all over that region and he regularly added enamel to scads of baby teeth in his own father's mouth.

Visit many many dentists before you make a decision as to whether to interfere. My adult tooth is safely in my upper gum, never bothered me, and never came down. To bring it down would require major surgery, disrupting the well-being of at least three other teeth. In the long term, you've damaged several teeth for the sake of one, and this is just not wise. But it took accumulated opinion for me to reach that conclusion. Lots of dentists were really eager to go in with the scalpel. Make sure you understand all the pluses and minuses before you listen to them. Also understand it really is common.
posted by Puppetry for Privacy at 7:49 PM on July 12, 2016

My mom is in her sixties and still has a baby tooth. Never caused any problems. If I were your child, I would want you to leave me alone.
posted by Violet Hour at 10:18 PM on July 12, 2016

I had to have my upper baby canines pulled when I was 16 because they just weren't going to fall out on their own. At the time, I wore braces already and visited an orthodontist regularly. Once they pulled the baby teeth and could get to the adult teeth above, they used braces to kind of pull them down faster than they would have otherwise come in (OT: painful!). My teeth turned out fine, but I did have the guidance of an orthodontist for the whole process and he made sure there was room for my teeth when they came in.

It's probably a good course of action to go to the orthodontist eventually, but you probably have some time; you'll know you're running out of time when the adult teeth start to come down (if they ever do). A consultation with an orthodontist in the meantime can't hurt to give you a sense of costs and insurance coverage.
posted by urbanlenny at 1:00 PM on July 13, 2016

I'm 37 and still have a baby tooth. There was no adult tooth under it to come up. I even forgot which one it was until I went to a new dentist a few years ago and based on the x-rays he sussed it out as a baby tooth, completely unprompted from me. It's given me exactly zero problems over the years and we don't ever expect that to change.
posted by Fuego at 9:07 PM on July 13, 2016

Just another one to say, I'm in my 30s and have a baby tooth. The adult tooth is just hanging out above it supposedly, and I was told that unless the baby tooth dies or breaks there's no reason to cut open my gums and draw down the adult tooth. So, I've gotten along fine with my little tooth!
posted by sweetmarie at 2:13 PM on July 15, 2016

I'm 46 and have two baby canines (uppers, one on each side). I'm actually missing the adult incisors, so the adult canines slid over (had braces for 6 months just to pull them down and over, and straighten them out.) Was told the babies would eventually fall out, but it hasn't happened yet.
posted by jindc at 4:17 AM on July 17, 2016

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