Impacted teeth

Down's Syndrom

Impedance of tooth eruption by adjecent or overlying tooth or bone

Cleidocranial Dysplasia

Congenital Hypothyroidism

Gaucher's Disease

Osteopetrosis

Rickets

Congenital hypothyroidism

is one of the preventable causes of mental retardation if diagnosed within first 3 months of life. Major complications can be prevented if diagnosed early and started on replacement therapy. Early diagnosis is difficult because the clinical signs are not apparent at birth and appear gradually. Thus it is very important to screen newborns for congenital hypothyroidism and it is a routine newborn screening test in most of the developed countries.

Thanks Vesna, the child is now eleven months old and has the normal developmental milestones. Everything is alright, no significant problems. except teeth.

Hello Naeem!

It is not uncommon to atend one year old patients whose primary teeth have not erupted in the mouth yet.

In most cases there are no local or systemic changes associated.

I suggest you to do a clinical examination of the child's gingiva, if it has normal characteristics, ie, volume compatible with the presence of dental germs inside, I see no reason for concern.

If the gingiva does not present this characteristic, or delay in eruption lasts for other months, you should consider a more detailed investigation.

A big hug!

Thanks Luiz Volpato

Like Luiz noted, there are children who erupt late. At the point of tooth eruption, they then erupt with multiple teeth. If the child has normal developmental growth and you have evaluated with evidence that all teeth are in the mouth (do an orthopanthomogram), then there is nothing to worry about. Ask the child to come in for regular monitoring reassuring the parents based on evidence available

Hi

First, the child will need continuous monitoring for this delayed eruption of his primary teeth. As the child was born premature, it is not uncommon to have delayed eruption of teeth in these children. However, most of them end up having normal set of primary teeth, unless they have some other concurrent medical condition. At this stage, if there is no other unusual oral finding, I will reassure the parents. If no teeth erupt for another 2-3 months, then we will have to go for a radiographic examination to see the situation in detail and decide an appropriate future strategy and support to parents and the child. Be in touch about how the case progresses.

Thanks Amjad Wyne

Pl check Vitamin D levels. That can be a cause for delayed eruption. Having said that, I would still wait for another three months before I start investigations in an otherwise healthy child, who is premature.

Hi

First of all it seems to be better to request the blood test to determine infant's T 3&4 hormonal levels( conservatively view),as functional problem of thyroid was reported in infant with premature birth .If it was rule out ,as it seem the infant is otherwise healthy follow up is be just option til nearly 18 months old.Delay in tooth eruption was reported in infant with premature birth . After a few months waiting if the teeth do not erupt ,radiography can help us to diagnosis of probably reasons such as dental missing that it was reported in infant with premature birth. Treatment plan can be design base on the number and area of missing teeth and proper time for intervention.

WITH BEST WISHES

It would be better to avoid radiography at this age since it is almost least possible to succeed due to patient's age or expose parents for assistance in this process.

Based on german opinion and studies, delay is acceptable till age of 18 month!

Hi all,

A 10 year old patient had extraction of mobile lower incisors for 3 months but the permanent incisors have been not erupted yet and therefore x ray has taken that showed the teeth were present in the jaw . What are the reasons for delaying in the eruption? Any advice....

Variation in the normal eruption of teeth is a commonfinding,butsignificantdeviationsfromestablishednormsshouldalertthecliniciantofurtherinvestigate the patient’s health and development. Delayed tooth eruption might be a harbinger of a systemic conditionoranindicationofalteredphysiologyofthe craniofacial complex. Orthodontists are often in a sentry position to perform an early evaluation of craniofacial structures, both clinically and radiographically. Proper evaluation of DTE in orthodontic diagnosis and treatment requires a clear definition of the term and its significance. We propose a diagnostic “tree” that would enable the clinician to perform an accurate and thorough orthodontic diagnosis of the patientwithDTE.

Malnutrition of mother