Losing their first baby teeth is an important milestone for your child. It marks a new stage in their growth, often calls for a visit to a pediatric dental care specialist, and might even trigger a visit from the Tooth Fairy (Or the Perez mouse, for Hispanic families).

However, this time of joy can be interrupted if you notice some of their baby teeth just don’t fall out. While it might come as a surprise, some children are actually born without permanent teeth to replace their primary ones. This condition—known as congenitally missing teeth—can lead to baby teeth remaining in place well into adulthood.

Here, we’ll explain all you need to know about this condition!

What Are Adult Baby Teeth?

As the name indicates, adult baby teeth (also known as retained baby teeth) refer to baby teeth that remain in place into adolescence or even adulthood. Often, this is due to not having a permanent one growing behind it.

To understand why this occurs, it's important to know how teeth develop. Primary (baby) teeth are the first set to appear, often erupting between six and ten months of age. By the age of three, all twenty baby teeth should have already erupted. Their permanent teeth start to form even before the baby teeth have erupted, and they force the primary teeth out when they begin growing in.

However, this lengthy process is completed in stages. It begins with the calcification of enamel and dentin, followed by the formation of roots. In the meantime, primary teeth play a valuable role in keeping their space. Once the permanent tooth is ready, it typically causes the root of the baby tooth above it to dissolve. This loosening process allows the baby tooth to fall out naturally.

But if there’s no permanent tooth waiting below, the baby tooth may stay in place—sometimes for life.

Can Adult Baby Teeth Cause Complications?

Adult baby teeth can lead to complications over time, as those with adult baby teeth often retain their second molars from childhood. Studies have shown a significantly lower chance of future dental issues if second molars are kept in place until the age of 20.

However, the same can't be said for other teeth. When children keep their incisors and first molars, they are more likely to require dental intervention. The primary risk of leaving adult baby teeth is tooth development issues, such as:

1. Infraocclusion

Infraocclusion happens when a baby tooth falls below the normal bite level because it cannot keep up with the eruption of nearby permanent teeth.

This typically occurs when there isn't a permanent tooth beneath the baby tooth to push it out. As a result, the retained baby tooth remains in its lower, initial position while other teeth erupt and align with the bite.

The primary tooth will appear "sunken in" compared to neighboring teeth. As a result, the surrounding teeth may tilt or drift into the gap, which could alter bite function and jaw alignment. Sometimes, infraocclusion can lead to bone loss around the affected tooth.

2. Occlusal Trauma

Occlusal trauma happens when the teeth are subjected to excessive or irregular force when biting or chewing. Baby teeth are smaller and shaped differently from adult teeth, so the bite may not close evenly when they remain. This misalignment may strain the jaw joint (TMJ) or specific teeth.

Other consequences include:

• Tooth wear, mobility, or fracture.

• Jaw pain, clicking, or headaches.

• Worse alignment over time affects chewing efficiency.

3. Diastema

A diastema is a gap or space between two teeth, most commonly the upper front teeth.

Baby teeth are often smaller than permanent teeth, so retained primary teeth may not fully fill the space and lead to noticeable gaps. Besides affecting aesthetics, diastemas can sometimes interfere with speech or cause food to get trapped between teeth, which may increase the risk of decay or gum irritation.

What Causes Adult Baby Teeth?

The most common reason baby teeth are retained into adulthood is the absence of permanent teeth to replace them—a condition that is often genetic. However, other factors can result in this situation, including:

• Hyperdontia: The presence of extra (supernumerary) teeth, which can block permanent teeth from erupting properly.

• Hypodontia: The absence of one to five permanent teeth.

• Oligodontia: The absence of six or more permanent teeth.

• Anodontia: The complete absence of all permanent teeth.

What Should I Do if My Child Retains Their Baby Teeth?

If the baby tooth is structurally sound, has a stable root, and doesn’t interfere with function or appearance, keeping it might be the best option for your child’s oral health. It can be maintained like their surrounding adult teeth with brushing, flossing, and regular visits to the dentist.

If your dentist suspects infra occlusion, they may suggest adding a molded cap to the top of the baby tooth. This helps maintain the space needed for a permanent tooth if it needs to be replaced in the future while protecting the integrity of the tooth structure.

If your child’s mouth is crowded or the baby tooth has become infected and abscessed, removal may be necessary. Afterwards, an orthodontist will help them successfully align their smile and restore their oral health.

When replacement is needed, dental restorations can be explored. It is not advised to use implants until after late adolescence, when the jaw has finished growing. However, they can get partial dentures in the meantime.

Protect Your Child's Smile with a Dentist Specializing in Pediatric Dental Care

If your child doesn’t have a permanent tooth to replace their primary one, there’s no need to worry. This condition is more common than many parents realize. This condition is more common than many parents realize!

Luckily, baby teeth are more resistant than you may think. In fact, some patients reach adulthood or even retirement with one or two primary teeth!

The only thing you can do is wait until the tooth reaches the end of its lifespan. When the time comes, you can then replace it with bridges, implants, or other restorative options offered at Perfect Smile Doc. If you have any questions or want to know if your child’s permanent teeth are growing properly, contact us today to set an appointment!