Paediatric Dentistry
Question and Answer

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Motherhood January 2008

1. My child's front baby teeth have started dropping out and new teeth are growing in to fill the spaces. However, the new teeth appear as if they have been chipped and the biting edges seem to look jagged and uneven. How could they be damaged when they are brand new and just cutting through the gums?

Without examining the teeth, it is not possible to say whether the new teeth have in fact been damaged or not. Newly erupting incisors normally do have uneven looking incisal edges, so it is possible that what appears as chips on the biting edges could just be the normal appearance of a newly formed incisor tooth. The ridges which appear in the newly erupting incisor teeth is simply due to the way the incisors develop. In the initial stages of development, incisors begin as three tubercles which join up as the crown of the tooth forms. Consequently, when the tooth erupts, these tell-tale signs of the way the tooth developed remains. The uneven edges usually smoothen out in time as the upper and lower teeth slowly wear down. Fractured teeth usually feel sharp around the edges of the fractured areas whereas a normal undamaged tooth feels relatively smooth, even though they have uneven surfaces.

2. My child's new teeth can be seen erupting behind the baby teeth but the baby teeth still feel firmly anchored in the jaw-bone. Should anything be done about it or will the baby teeth drop out naturally eventually? It does look funny at present, like a second row of teeth is forming.

Occasionally, we encounter teeth which do not grow in the proper position or in the proper direction. When we see the new tooth starting to grow out of position, it is advisable to extract the baby tooth which does not drop out to make room for the new tooth. If the baby tooth is left alone, it will prevent the new tooth from growing into its proper position. The longer the offending baby tooth is left in position, the more crooked the new tooth will grow. This will result in a crooked set of permanent teeth and would require correction by means of braces later on. It is therefore very important, if you wish to spare your child from having to undergo a long period of orthodontic treatment, to take your child to your dentist as soon as you notice this happening, to let the dentist assess the situation.

3. I notice my child's new teetlh are much darker than the baby teeth were. No amount of brushing seems to be able to remove the dark colour. Does this show that the second set of teeth will be weaker than the first set?

We find that in practically all cases, the permanent set of teeth look darker than the primary or milk set. This is not necessarily a sign that they are any weaker as long as the teeth are within the normal colour range and have a healthy translucent appearance. The deeper colour of the permanent set of teeth is due to the fact that they are larger teeth, and have a thicker layer of hard tooth structure which contains the teeth's pigmentation. In brushing the teeth, one can only manage to remove dirt particles from the surfaces of the teeth. It is not possible to remove the pigmentation inside the tooth structure. In cases where the teeth are abnormally dark, they could be treated by various methods of teeth whitening, usually preferable when the person reaches a more mature age.

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