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Wednesday, July 30, 2014
Dental and Oral Health (Children)
Lost central incisors in 6 year old girl
My daugther`s mouth has aged quickly. She is 6 years old and has lost 8 baby teeth. She got her permanent central incisors about six and three months ago (left six months ago...right three months ago). Two weeks ago, she tripped and fell on a playground, hitting the wooden surface. She lost a baby tooth, and hit her permanent central incisors. While they were not imbedded up into the gum, the gum was bruised along with bloody lip, etc. I took her to her dentist`s house that night; he examined her and determined that the more mature tooth was slightly loose, but advised soft foods. Five days later, at my son`s birthday party, I was taking pictures of the birthday cake-fest, and noticed that my daughter`s central incisors were GONE!! Twenty five adults searched in the grass for two hours and never found them. We had her x-ray`d at the dentist and at the hospital to see if they were in her gum, or in her stomach. Nothing. My daughter does not recall losing them. We`re working locally with three well established professionals -- oral surgeon, orthodontist, dentist. However, I`m gathering all the information I can to determine our best route of care. Your opinion/thoughts, and, in particular, information of a similar case, would be greatly appreciated.
I will tell you that your current approach is EXACTLY the right thing to do. A situation involving dental trauma / early loss of primary teeth warrants a multi-disciplinary "team approach" and having a dentist, orthodontist, and oral surgeon coordinating care is a good game plan.
The specifics of the case involving the location of permanent teeth / eruption questions, etc. really are beyond my scope in that I do not have access to radiographs or a clinical examination. I would, however, recommend an evaluation by a pediatrician in that early loss of teeth can be hormonally based as well.
I hope this helps and good luck!
Sarath Thikkurissy, DDS, MS
Director, Residency Program, Division of Pediatric Dentistry and Orthodontics
College of Medicine
University of Cincinnati