Is your child’s permanent tooth missing or not coming in? Learn common causes, treatment options, and when to see an orthodontist in Lubbock and Seminole, TX.
What Happens If a Permanent Tooth Won’t Come In?
One of the most common questions parents ask is:
“My child’s permanent tooth still hasn’t come in. Should I be worried?”
In many cases, a delayed tooth eruption is completely normal. However, there are times when a permanent tooth becomes trapped beneath the gums or bone and needs orthodontic treatment to help it erupt properly.
At Parker Wentz Orthodontics, we frequently evaluate children and teenagers who have a missing permanent tooth, delayed eruption, or impacted canine. Early diagnosis can often simplify treatment and help prevent future complications.
What Is a Delayed Eruption?
A delayed eruption occurs when a permanent tooth does not come into the mouth within the expected timeframe.
Every child develops differently, but if one side has erupted and the matching tooth on the other side has not appeared after several months, it may be worth having an orthodontic evaluation.
Common examples include:
- Upper canine teeth (“eye teeth”)
- Upper front teeth
- Premolars
- Lower canine teeth
Sometimes the tooth is simply developing more slowly. Other times, the tooth may be blocked from erupting normally.
Why Won’t My Child’s Permanent Tooth Come In?
Several factors can prevent a tooth from erupting properly.
1. Lack of Space
Crowding is one of the most common reasons permanent teeth become delayed or impacted.
If there is not enough room in the dental arch, the tooth may remain trapped beneath the gums.
This is one reason why the American Association of Orthodontists recommends children receive an orthodontic evaluation by age seven.
Learn more about our early treatment philosophy here:
https://parkerwentzorthodontics.com/early-orthodontic-treatment/
2. Impacted Canine Teeth
Canine teeth are among the most commonly impacted teeth after wisdom teeth.
These teeth play an important role in both function and smile aesthetics. When they become impacted, they may remain hidden within the bone and require orthodontic treatment to guide them into position.
At Parker Wentz Orthodontics, impacted canine treatment is a condition we regularly evaluate and manage.
3. Retained Baby Teeth
Sometimes a baby tooth does not fall out when it should.
The retained baby tooth can block the permanent tooth from erupting into its proper position.
In many cases, removing the baby tooth allows the permanent tooth to erupt naturally.
4. Missing Permanent Teeth
Some patients are born without certain permanent teeth.
This condition is more common than many people realize and often affects:
- Upper lateral incisors
- Lower premolars
When a permanent tooth is missing, orthodontic treatment can help create the best long-term solution.
How Do Orthodontists Find the Problem?
A clinical examination alone does not always tell the full story.
At Parker Wentz Orthodontics, we use advanced imaging technology to determine:
- Whether the tooth is present
- The position of the tooth
- Whether neighboring teeth are being affected
- Available space for eruption
- The best treatment approach
Early diagnosis is often the key to avoiding more complicated treatment later.
What Treatments Are Available?
Treatment depends on the cause of the eruption problem.
Options may include:
Monitoring
Some teeth simply need more time.
Regular follow-up visits allow us to monitor development and ensure the tooth is moving appropriately.
Creating Space
When crowding is the issue, orthodontic treatment may be used to create room for the tooth to erupt.
This may involve braces, expanders, or clear aligners depending on the situation.
Learn more about our clear aligner treatment:
https://parkerwentzorthodontics.com/clear-aligners-seminole-tx/
Exposure and Orthodontic Guidance
For impacted teeth, a minor surgical procedure may be performed to expose the tooth.
An orthodontic attachment can then be used to gently guide the tooth into its correct position.
Long-Term Treatment Planning
If a permanent tooth is missing, orthodontic treatment can help prepare the smile for the best long-term restorative option.
When Should Parents Schedule an Evaluation?
Consider scheduling an orthodontic evaluation if:
- A permanent tooth appears significantly delayed
- A baby tooth remains in place long after expected
- One side of the mouth is erupting differently than the other
- Your child has significant crowding
- Your dentist has expressed concerns about eruption patterns
The earlier we identify a problem, the more treatment options are typically available.
Why Early Orthodontic Evaluations Matter
Many parents assume orthodontic treatment begins when all permanent teeth have erupted.
In reality, some of the most important orthodontic decisions happen years before braces are ever placed.
An early evaluation does not always mean treatment is needed. Often, it simply allows us to monitor growth and development and intervene only when necessary.
Schedule a Complimentary Orthodontic Evaluation
If your child has a permanent tooth that has not come in, Parker Wentz Orthodontics can help determine the cause and discuss the best treatment options.
Dr. Parker Wentz is a board-certified orthodontist and third-generation orthodontist serving families throughout Lubbock and Seminole, Texas.
Whether treatment is needed now or simply monitored over time, our goal is to help every child achieve a healthy, functional smile.
Schedule your complimentary consultation today.
Parker Wentz Orthodontics
Lubbock & Seminole, Texas
806-412-0142
Frequently Asked Questions
Is it normal for a permanent tooth to come in late?
Sometimes. However, if a matching tooth has erupted on the opposite side and several months have passed, an orthodontic evaluation may be recommended.
Which teeth are most commonly impacted?
Upper canine teeth are among the most commonly impacted teeth that orthodontists treat.
Can an impacted tooth be saved?
In many cases, yes. Early diagnosis often improves the likelihood of successfully guiding the tooth into position.
At what age should my child see an orthodontist?
The American Association of Orthodontists recommends an orthodontic evaluation by age seven, even if braces are not expected anytime soon.