The tooth you never had: are they hidden inside?

Do you not have your complete set of 32? Well! It’s pretty common. Most people have a few teeth missing. The most common of these teeth are the wisdom teeth and the lateral incisors (these are the teeth that are present on side of the front teeth).

If you don’t have your lateral incisors or wisdom teeth, GOOD NEWS!

You are more evolved than the rest of the human population. These teeth are considered vestigial and do not serve any purpose. They are just an extra set of teeth.

It is extremely important to ALWAYS check that why are you missing certain teeth. In certain scenarios these teeth aren’t formed; this is more common with the lateral incisors. With any other tooth including the wisdom teeth, the absence could signify some underlying dental issue.

So, why do teeth go missing?

·        There isn’t enough space in the jaw to accommodate the tooth:  The teeth are for a larger part embedded in the jaw than they are seen outside. If either of the jaws are small, then there isn’t enough space in the jaws to accommodate all the teeth. Thus these teeth don’t get a chance to come out in the mouth and remain embedded. In this type of missing teeth, generally the same tooth is missing on both the sides of the jaw.

Which teeth are more commonly effected?

The second premolars and the canines are the last teeth to erupt. Thus, these are the teeth that do not have enough space left to come out, and remain inside the jaws.

What are the consequences if ignored?  

1.     One of the most common consequence of ANY tooth that is left behind in the mouth is the formation of a cyst around it. Cyst is a hollow space which is lined by cells and filled with fluid. There are multiple types of cysts, but some of them can grow to a huge size and cause swellings in the bone and nerve damage, while others can turn cancerous. Thus it is extremely important to check for any missing teeth. Even when there is no space between the teeth.

2.     These type of missing teeth are generally associated with crooked and malposition in teeth. Malposition in teeth should be corrected, because, not only are they unpleasant to look at, but chewing with such teeth can be extremely damaging causing the teeth to wear off rapidly and even fracture at times. 

·        The tissue overlying the tooth is too thick: When the tooth is erupting in the jaw it has to tear through the tissue in which it is embedded. At times this tissue is extremely fibrous. The force of the erupting tooth isn’t enough to tear through this fibrous tissue, resulting in the tooth not erupting in the mouth.

Which teeth are most commonly affected:

Any tooth can be affected in this situation. A more fibrous soft tissue can be due to an injury or fall. So the area that was the most damaged, would have the highest amount of fibrous tissue.

What are the consequences if ignored?

1.     There would be an empty space in the jaw where the tooth should’ve erupted. This along with being unaesthetic, would also cause the adjacent teeth to tilt and the opposing teeth to erupt more towards the empty space. All these factors would finally reduce the efficiency of chewing.

2.      The formation of a cyst around the tooth that is inside the jaw

·        The tooth is positioned too far up in the jaw:

As an embryo the face grows downwards. Sometimes, due to a developmental error the tooth remains high up in face. At times the tooth might be closer to the nose than to the mouth. It is so far away from the jaw that it fails to erupt. This is generally the case with permanent teeth, and in such a situation the milk teeth in that position do not fall off.

Which teeth are most commonly affected?

 The canines. Being the last tooth to form they sometimes do not descend down. Again, more common during an injury. The canine milk tooth could be in place in such cases

What are the consequences if ignored?

1.     The milk tooth if retained is smaller and has reduced strength than a permanent tooth. It would either wear off very rapidly, with the growing strength of the chewing muscles or eventually fall off. Also, the milk teeth being smaller looks unpleasant when compared with the other permanent teeth in the same jaw.

2.     The formation of cyst in the tooth that didn’t erupt.

3.     The empty space/smaller tooth causes the adjacent teeth to tilt in the available space.

·        The tooth is placed in the wrong position in the jaw

At times the teeth are rotated or in a totally sleeping position. Also sometimes the root of the tooth that is in the mouth obstructs the eruption of the tooth that is in the jaw.

Which teeth are most commonly effected?

The wisdom tooth by far is the almost the ONLY tooth effected by this condition. Being the last tooth, it neither has enough space, and generally the 2nd molar tooth interrupts the eruption of this tooth.

What are the consequences if ignored?

1.     The un erupted tooth applies pressure on the tooth that is blocking its path of eruption. This depending on the position of the un erupted tooth results in either the disintegration of the root of the erupted tooth or a cavity in the erupted tooth.

2.     The formation of a cyst

3.     Being an extremely common experience in that of the upper teeth is that the wisdom teeth erupt towards the cheek. They then cause frequent cheek biting. Constant irritation to the cheek can cause frequent ulcers which can turn cancerous if ignored.

·        The tooth already has a cyst/pathology around it

Although pathologies around a tooth aren’t very common; it is important as the pathology might be cancerous or have the potential to turn cancerous.

Which teeth are most commonly effected?

Any tooth can be affected by this condition. Different pathologies have a different preference of the area of the jaw they like to involve.

What are the consequences if ignored?

If the cyst is ignored for extended periods of time they can

1.     Cause the bone to expand

2.     Cause damage to the surrounding blood vessels and nerves

3.     Convert into cancerous tissue

4.     Grow into very large structures that then could compress vital structures like the breathing tube.

 What is the treatment if you have a tooth embedded in your jaw?

If you feel you’ve got a missing tooth, you would need a full mouth x-ray and evaluation

There are multiple treatment options, including cutting through the fibrous tissue after which the tooth erupts by itself; or uncovering and pulling out a tooth that is too deep inside.

The most important part is that if you feel you have got missing teeth or your teeth set doesn't seem the same as that of everyone else


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