What A Dentist Can Do When One Of Your Child's Permanent Teeth Didn't Develop

Teeth emerge from the gums, grow vertically (ideally, anyway), and eventually reach their full size. This natural process has a rather dramatic name, which is "eruption." Teeth don't in fact grow—they erupt. Or at least, they should. Some young adults might find that an isolated tooth has failed to erupt; it formed, but remained submerged in the gums. If one of your child's teeth refused to erupt, what can a dentist do to help?

Old News

Chances are that you, your child, and your family dentist are fully aware of the unerupted tooth. Further investigation would have been performed when the tooth remained conspicuously absent, despite the loss of the baby tooth in the same position. In rare cases, an unerupted tooth can be left where it is (with regular monitoring). Some patients may be able to have their tooth coaxed into erupting with orthodontic treatment. However, many patients will eventually require a tooth extraction.

Multiple Potential Problems

Tooth extractions for unerupted teeth become necessary when the tooth begins to endanger neighbouring teeth—or when it's suspected that this will soon become an issue. The irregular position of unerupted teeth can lead to multiple potential problems. A cyst may develop next to the submerged tooth, and the whole tooth can become a focal point for infections.

Neighbouring Teeth

The presence of an infection means an unerupted tooth can be quite painful, which won't be fully alleviated until the tooth is extracted. Depending on the angle of the tooth, it may be pressing against the roots of neighbouring teeth. This can dissolve these roots (a process called root resorption), which can weaken the teeth. 

Planning for Extraction

A dentist will take a close look at the tooth with an x-ray, noting its precise position, its size, its angle, and its root system (whether it has a standard layout, or its roots are fused). This allows a dentist to plan the tooth extraction. An incision will be made in your child's gums, and the tooth will be excavated, and then removed. Your child will be given appropriate pain relief, and sedation is possible for especially anxious patients. 


Once the extraction site has healed, you can begin to discuss replacement options with your family dentist. If the tooth was to the side of the dental arch, your dentist might refer your child to an orthodontist—as braces can be used to reposition the teeth on either side of the gap to actually close the gap. A temporary prosthesis (partial dentures, or a dental bridge) is another option, and when your child's jaw has reached full size, a permanent dental implant can be fitted.

An unerupted tooth has the capacity to cause major damage. If one of your child's teeth failed to erupt, be prepared for the fact that one day extraction is likely to be needed.