Options for a Child Missing Permanent Teeth

When a young child loses a baby tooth, it may be a cause for celebration (and a visit from the tooth fairy). But if an older child or teenager loses a permanent tooth, the picture isn’t quite so rosy. While it’s generally desirable to replace a permanent tooth soon after it is lost, the situation is more complicated in young people, whose jaws are still growing. In this case, your dentist may advise waiting to put in a permanent tooth replacement (such as a dental implant) – perhaps until the late teens or early twenties. Here’s why this situation may arise, and what to do about it.

Some children lack one or more permanent teeth due to a congenital (inherited from birth) condition. Others may have suffered a dental trauma, such as an injury while playing sports. (Few, we hope, have lost teeth due to untreated tooth decay or gum disease, the main causes of tooth loss in adults). A state-of-the-art dental implant is today’s gold standard for replacing missing teeth. However, it’s not advisable to place a dental implant while the jaw is still growing, because it could end up being misaligned when growth is complete. So what can be done in the mean time?

For both aesthetic and functional reasons, no one should go for long without a tooth. Fortunately, there are two good options for temporary tooth replacements: removable partial dentures and bonded bridges (also called “Maryland bridges”).

A removable partial denture (RPD) is a lifelike false tooth set into a gum-colored base. There are a few different types available; all can be easily removed, yet are tough enough for several years of everyday usage. Wearing an RPD may take a little getting used to, but most people adapt very well in a short time.

A bonded bridge resembles traditional dental bridgework, with one major difference: Instead of fitting over adjacent teeth (which must then be reduced in size, shaped and capped), a bonded bridge has protruding “wings” on either side, which are bonded to the backs of neighboring teeth. This type of bridge isn’t quite as strong as a traditional bridge, and it may not be appropriate for everyone – but it looks natural, and it can hold up well for years.

Which one is right for your child or teenager? Your dentist can help you understand what the options are, and can make an appropriate recommendation.


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