Adult Baby Teeth: Understanding Retained Primary Teeth and When to Seek Dental Care

Have you ever wondered why some baby teeth, also known as primary teeth, never fall out, even into adulthood? While most children eagerly anticipate the tooth fairy and the eventual arrival of their permanent teeth, a surprising number of adults go decades unaware they still have primary teeth. This phenomenon, known as retained primary teeth, can lead to questions and concerns about oral health. According to the American Dental Association's MouthHealthy, children typically develop 20 primary teeth starting around six months of age, which gradually shed throughout childhood to make way for up to 32 permanent teeth by age 21. However, in some individuals, this natural progression doesn't occur, resulting in retained primary teeth. Several factors can contribute to primary teeth not falling out. One common cause is tooth agenesis, a condition where the permanent teeth meant to replace the baby teeth are simply missing. Additionally, dental injuries or infections experienced during childhood can sometimes impede the proper eruption of permanent teeth. The question then arises: should you be concerned if you have retained baby teeth? The answer isn't straightforward; it depends on the individual case. In many instances, a retained primary tooth can function perfectly well, with healthy crown, roots, and supporting bone structure. A systematic review published in the European Journal of Prosthodontics and Restorative Dentistry (EJPRD) even indicated that retained deciduous teeth can have a reasonable survival rate for at least two decades. Long-term studies beyond this period are less common. However, retained primary teeth can also be associated with certain oral health issues. These may include root resorption (the breakdown of the tooth's root), infraocclusions (where the retained tooth's biting surface is lower than adjacent teeth), dental caries (cavities), and periodontal bone loss. When it comes to treatment, the decision to extract a retained baby tooth in an adult is highly individualized. If the tooth is well-aligned and helps maintain the bone and tissue structure of the mouth, especially in cases of tooth agenesis where permanent teeth haven't erupted, extraction might not be necessary. Conversely, if a permanent tooth is impacted—meaning it's blocked from erupting through the gumline—the Open Dentistry Journal suggests that extracting the retained baby tooth can allow for the spontaneous eruption of the permanent successor. For extracted retained deciduous teeth, dental implants are considered a highly successful long-term treatment option, while resin-bonded bridgework can be a viable short-to-medium-term solution. Ultimately, the decision regarding treatment for retained primary teeth is a significant one that should be made in consultation with a dental professional. Your dentist or orthodontist is the best resource to answer your questions and guide you toward the most appropriate course of action for your specific situation. While discovering a retained baby tooth might be a surprise, with proper care and professional guidance, it can continue to serve you well for many years, or if necessary, be expertly addressed.