When permanent teeth emerge while baby teeth are still present, a phenomenon commonly known as "retained baby teeth," it is a frequent occurrence in children during their tooth replacement phase. This condition primarily results from a slow or incomplete resorption of the baby tooth roots, preventing the teeth from loosening and falling out at the appropriate time. Consequently, the permanent teeth tend to erupt inwards, leading to misalignment.

Parents should take their child to a specialized Maxillofacial Dental department for an examination. A dentist may recommend a periapical X-ray to accurately assess the extent of baby tooth root resorption. If the root has not resorbed and the tooth is not loose, the dentist will gently administer a local anesthetic and extract the baby tooth to make way for the newly emerging permanent tooth.

After the baby tooth is removed, the permanent tooth will gradually shift into its correct position. This natural adjustment is facilitated by the tongue's pressure and the development of the jawbone, often without requiring early orthodontic intervention.

If a baby tooth has been loose for two to three weeks but has not fallen out naturally, parents should seek dental advice. Prolonged retention of a loose baby tooth while permanent teeth are starting to emerge can increase the risk of tooth misalignment and malocclusion later on.

A loose baby tooth can also create gaps where food can get trapped, making oral hygiene difficult and increasing the risk of gingivitis and bad breath. This situation can also lead to decay in the erupting permanent tooth and adjacent teeth. If this condition persists, it can hinder chewing function, causing the child pain, discomfort, and a reluctance to eat. Children may also develop habits such as using their hands to pry or their tongue to push the tooth, which can increase the risk of infection and further shift the permanent teeth.

However, the ability for self-correction depends on the degree of misalignment, the remaining space in the dental arch after the baby tooth is extracted, and the child's age.

Doctor Ta Vu Anh Duong discusses a child's dental condition with a parent. Illustration: Tam Anh General Hospital

Parents should schedule regular dental check-ups for their children every three to six months or whenever any abnormalities are noticed. Through these examinations, dentists can detect misaligned permanent teeth early and recommend timely extraction of baby teeth, guiding the new teeth into their correct positions. This proactive approach helps children develop a balanced jaw structure, a proper bite, and a set of even, healthy teeth as they grow.

Doctor, Level I Specialist Ta Vu Anh Duong

Department of Maxillofacial Dentistry

Tam Anh General Hospital TP HCM