Hey Dr. Hall,
I was reading your answer to Cathryn from California. I’m 16 as well and still have my baby teeth but the problem is my adult teeth grew behind my baby teeth. And it’s been like this for years now. I would like to know if this can be fixed?? Please help.
(See Dr. Hall’s answer below.)
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You have a very different situation from Cathryn from California, who I answered earlier. Her adult canine teeth hadn’t erupted, and that’s why she still had her baby canine teeth. You’re telling me that you still have your baby teeth but also your permanent teeth are all in.
I’d need to know more to give you a more specific answer, but let me see what I can tell you to help.
First, to answer your general question, yes, this can be fixed with orthodontics. I’m not sure how many teeth we’re talking about, but as long as the permanent teeth have erupted, and it sounds like you’re telling me they have, they can always have brackets attached to them and be moved to their correct positions.
As far as exactly how to proceed, that depends on the situation. If all the permanent teeth are present, you’ll be wanting all the baby teeth taken out. You may even need some permanent teeth extracted, too, because it’s sounding like things must be crowded in your mouth.
I have a couple of additional things to say about this situation.
First, if a baby tooth doesn’t come out on its own and the permanent tooth appears, breaking the surface of the gums, best practice would be to take out the baby tooth. Otherwise, the baby tooth will tend to deflect the permanent tooth into an incorrect position. Had that been done in your case, it doesn’t necessarily mean that you would be guaranteed to not need orthodontic treatment, but if you did, it would be simpler and you would have less of a jumbled mess in your mouth. Taking the baby tooth out clears an eruption path for the permanent tooth.
Second, your question gives me an opportunity to say something about retained baby teeth and how to manage them. Sometimes there’s a missing permanent tooth (a congenitally missing tooth), which means that you will not lose the baby tooth. This will usually be a maxillary lateral incisor, or a mandibular premolar.
For mandibular premolars, my usual practice was to maintain these teeth with fillings or whatever they needed, as long as it is in a good position and aligns properly in the bite. They will often end up falling out eventually because of their inadequate root structure. I had one patient whose baby molars I maintained for many years and finally, when she was in her fifties, they fell out.
For maxillary lateral incisors, they are most often displaced by the maxillary canine teeth, and so the patient ends up with a missing tooth. Here’s a photograph, courtesy of Dr. Thomas Chai of Sydney, Australia:
This patient has one retained baby lateral incisor on her right side (our left). On the other side, when the canine erupted it caused the other baby lateral incisor to be lost. In this situation, I would have an orthodontist separate the patient’s left canine and central incisor, take out the baby incisor, and place implants replacing the lateral incisors.
– Dr. Hall
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