Patient's Query
Hello doctor,
This query is for my daughter who is 6 years and 7 months old. She lost her top primary incisor teeth (universal numbering 9) before four months. She still has not got the permanent teeth until now. She however, has lost the other three incisors and got the permanent teeth. She is taking Eltroxin 25 mg since birth. Kindly do let me know if the above delay in the growth of these teeth is normal.
Hello,
Welcome to icliniq.com.
As you mentioned your daughter is 6 years and 7 months old. Please confirm if she has lost all her upper primary teeth or lowers where the permanent teeth have come? Other thing is if all the upper four primary incisors are gone and three have come. Generally, we need to see which tooth incisor has not come out of four permanent incisors. If missing tooth is lateral incisor means next to two central incisors then we can wait and watch for another two to three months.
Other scenario is if only one upper incisor is lost three to four months ago and the rest of the milk (primary incisors are intact) then we can still wait two to three more months. But if out of four upper permanent incisors, only one that too central permanent incisor has not come out, then it is better to take radiograph IOPA (intraoral periapical radiograph) X-ray first to rule out any hindrance in the eruption of the tooth or any permanent missing tooth.
If possible click and share the picture of mouth (oral cavity) with teeth and send it across.
Generally, a delay of one year in an eruption of permanent teeth is quite normal. But we need to confirm which tooth is missing and need to see the chronology of other teeth simultaneously to rule out any abnormal changes.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
My daughter has lost both her upper and lower primary teeth, out of which 3 of the permanent incisors have come. I am attaching a photo for your reference. I am also attaching herewith a photograph of her mouth for your reference.
She had two of her teeth filled when she was 3 years old as she formed that cavity due to acid reflux (she was suffering from moderate GERD and she is not fond of sweet or chocolate products).
Hi,
Welcome back to icliniq.com.
Thanks, for sharing the intraoral picture. I can see a bulge in the gum, and looks gum are bit thickened. One of the reasons for the tooth not coming on time is thickened gingiva or gum, as I can see in the picture shared by you. Another very rare thing is if someone is hypothyroid, chances of delay in tooth eruption are normal.
As the gum is thickened, I would recommend you to massage the gum area regularly with their finger and try giving her a cold carrot, cucumber, or radish in small pieces which can touch the lower tooth and gum area, and tell her to bite over it. Same as we give teethers when a new tooth erupts for first time. Try massaging with this technique regularly.
I would recommend waiting for at least one more month with this exercise. As mentioned in my last reply delay of one month is quite normal. If gum gets more thicker. We can examine and take an X-ray to rule out any other pathology and most likely have to remove a part of the gum to make the tooth erupt smoothly. Removal of gum is not an invasive procedure and can be done with minimum use of local anesthesia or spray. That is also the last resort. Need not worry at least for now.
I hope this helps.
Thank you.
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Answered byDr. Paras Angrish
Medically reviewed byDr. Vinodhini J.
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