Ask The Dentist is a series of columns written by Dr. Mady to answer your questions about dentistry and oral health!
Dear Dr. Mady: My fourteen year old son has not lost any of his baby molars yet. Is this normal? I thought a fourteen year old would not have any baby teeth left at all. - Cathy V. in Windsor
Dear Cathy: When we talk about children losing baby or primary teeth, we generally speak in relation to averages. The average age for losing primary molars is eleven to twelve years of age. Many children and adolescents will shed their primary molars earlier or later than this and there can be other contributing factors involved.
You may think that fourteen is an abnormal age to be in this position, but being in dental practice myself, I can assure you that this is not as uncommon as you may believe. I have seen many cases over the years with individuals where some of the permanent teeth do not develop at all. If this is the case, then the baby tooth that precedes it will not exfoliate when it is supposed to or maybe not ever.
The four teeth that replace the primary molars are known as premolars or bicuspids. It may be possible that patients have not developed some or all four of these permanent premolars under the primary molars. A dental x-ray (radiograph) will confirm whether or not this is the diagnosis. However, it is rare that all the premolars remain undeveloped. If these premolars are present, an x-ray will confirm that and also display the stage of development of these teeth.
Permanent teeth will generally erupt when their roots are approximately two-thirds formed. If the permanent root development is slower, this will delay eruption.
On occasion, primary teeth will not come out due to a condition known as ankylosis. Ankylosis is a dental situation in which the roots of primary teeth lose their normal attachment to the bone (small ligaments) and become fused directly
to the bone. The cause of this is not known, but it is seen fairly often, particularly in lower primary molars. If this condition is present, the baby teeth practically become bonded into the jaw bone and it is very difficult or impossible for them to exfoliate on their own or even to be extracted by a dentist or oral surgeon. In this case the permanent teeth will never erupt until the preceding baby tooth is absent and they may, in the meantime, try a different path of eruption and end up in the wrong place.
I have patients in my own practice that have retained primary molars and other teeth and some are into their fifties and sixties without a problem. There are many treatment modalities and options.
I would not jump to conclusions until an x-ray and a visit to your dentist is completed. Most likely, he is a bit behind schedule with his dental development. One trip to your dentist will undoubtedly answer your question and set your mind at ease.