Dental Treatment Guide for Over-Retained Teeth in Kids – Part II

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Retain Primary Teeth
If the coronal structure and the root of the teeth are in good condition, it means their functionality and aesthetic appearance are acceptable. For such a case, a dentist opts to retain the primary teeth intact in the dentition and monitor it. Since tooth extraction isn’t required, orthodontic intervention may not be necessary.
Retaining a permanent tooth is usually recommended when the primary tooth gets fused to the bone and there is no permanent tooth to replace it. It’s not uncommon to find older adults with a retained primary tooth. Primary teeth are natural space holders and removing them too early can create undesired spaces between the teeth. The major benefit of this procedure is that it needs minimal maintenance and the retained primary teeth preserve the bone and soft tissues surrounding the teeth.
However, good oral hygiene is required to maintain retained primary teeth. If the primary teeth fail, there could be either insufficient or excessive space in the gums, depending on the size and shape of the teeth. An orthodontist should be consulted to open or close these spaces, especially if a child has several missing permanent teeth. A dental implant is the most common solution suggested when you lose a retained primary tooth.
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Retain and Modify
When the root and crown of the primary teeth are in good condition, but aesthetic improvement is required due to submergence of the teeth, it can be retained and modified. Submergence of the teeth means they’re lower in height and dimension than the adjacent teeth.
The modification is mostly done by reshaping the teeth with tooth-coloured filling material. A retained and modified primary tooth requires close monitoring for several years.
Note that in case of severe submergence of certain teeth such as a primary or secondary molar, early extraction is recommended. This is because if extraction is delayed, it may lead to bone loss and will require surgical removal later.
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Extraction
If a primary tooth is fused to the bone and permanent tooth is present to replace it, a dentist will recommend tooth extraction. After extraction, the empty space is filled with a space maintaining device to keep this space available for the permanent tooth to erupt in position. If there is no permanent tooth present to replace the primary tooth, space is maintained with the device for a future dental implant. This space needs periodical dental checkups during the erupting process to avoid abnormalities.
For children suffering from over-retained primary teeth due to permanent teeth misalignment, orthodontic procedures are recommended. An orthodontist can advise you both short-term and long-term solutions suitable for your child.
Early detection and proper treatment are important considerations for a beautiful smile that lasts a lifetime. Visit a dental office with your child and schedule regular dental checkups.
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