My adult teeth are behind my primary teeth, and I turned 17 years old in August. It’s been several years, but my primary teeth are not loosening. My pediatric dentist suggested braces, but I don’t understand how that would help. The problem is that it’s like I have two sets of teeth. How can this be corrected? Thank you – Erin
Thanks for submitting your question to us. Although Dr. Finley or Dr. Henderson would need to examine your teeth for an accurate diagnosis, we’ll tell you what we can.
Permanent Teeth Behind Primary Teeth – Can Orthodontics Help?
Orthodontics can reposition permanent teeth that are behind primary teeth if the permanent teeth have erupted. An orthodontist or a dentist trained in orthodontics can attach brackets to your permanent teeth to assist with the movement. So, your pediatric dentist is correct.
Extractions – The exact method with orthodontics depends on how many of your permanent teeth erupted behind a primary tooth. An orthodontist or dentist will extract the primary teeth and perhaps some permanent teeth if they are crowded.
Preventive Care for Primary Teeth that Don’t Come Out
If a primary tooth doesn’t come out and make room for a permanent tooth, the best practice is for an orthodontist to remove the primary tooth. Removing the primary tooth creates space and can decrease the permanent tooth’s risk of erupting in the wrong position.
Managing Primary Teeth That Prevent Permanent Teeth from Erupting
Although each patient case is unique, below are some ways that a dentist might manage primary teeth that don’t fall out and prevent permanent teeth from erupting.
- Genetically missing teeth – If your permanent tooth (usually an upper incisor or lower premolar) is missing due to genetics, you won’t lose the primary tooth.
- Lower premolar teeth – Some dentists maintain lower premolars with fillings if the teeth are not misaligned or disturbing your bite. Lower molar teeth often fall out because they lack a strong root structure.
- Upper lateral incisors – Upper canine teeth often displace the lateral incisors and result in a missing tooth.
The photo on this page, courtesy of Dr. Thomas Chai of Sydney, Australia, shows a patient with one primary lateral incisor on her right side (our left). On the other side, the canine erupted and caused the other primary lateral incisor to be lost. An orthodontist can separate the patient’s left canine and central incisor, remove the primary incisor and replace the lateral incisors with dental implants.
Your pediatric dentist will help you find an orthodontist who can reposition your permanent teeth and give you a confident smile.
David Finley, DDS, a Monroe, LA dentist and Fellow of the Academy of General Dentistry, sponsors this post.