What Should You Do If Your Baby Tooth Won't Come Out and Is Still Hard?

When dealing with a persistent baby tooth that has not fallen out and is still hard, it's important to seek professional advice. This issue can be attributed to different underlying causes, and the best course of action largely depends on these causes.

Assessing the Situation

It's crucial to visit a dentist for a thorough evaluation. There are two primary scenarios to consider:

1. Permanent Tooth Is Present but Baby Tooth's Roots Are Not Dissolving

In this case, if the permanent tooth is developing but the baby tooth's roots are not dissolving as they should, the alignment of your permanent teeth can be affected. As a result, the permanent tooth may become misaligned or impacted. This situation can be detrimental to your dental health, and the best course of action is to have the baby tooth extracted by a dentist.

2. Permanent Tooth Is Missing

There are situations where the permanent tooth underneath the baby tooth might be missing, particularly with second bicuspids, which replace baby 2nd molars. In such cases, it may be advisable to retain the baby tooth to maintain the integrity and alignment of the rest of your teeth. In the future, if the baby tooth is lost, it may still be possible to replace it with an implant. I've had patients in their 40s in this situation.

Key Diagnostic Tools

To make an accurate decision, your dentist will employ diagnostic tools like a periapical radiograph. This imaging technique provides valuable insights into your teeth's condition, including:

The presence of a permanent tooth The condition of the permanent tooth, including bone coverage and growth stage The direction of the permanent tooth's eruption The location of the permanent tooth within the jawbone

Recommendations Based on Dentist Evaluation

Based on the dentist's findings and evaluation, they will recommend the appropriate course of action:

If no permanent tooth is present beneath the baby tooth and the baby tooth has a functional condition, you may choose to keep it. If the permanent tooth is present, your dentist may use orthodontic treatment to guide the permanent tooth into the proper position. Alternatively, they may recommend extracting the baby tooth and replacing it with an implant.

It's important to note that this information is provided for informational purposes only and is not intended to substitute for professional medical advice. In California, dental hygienists are prohibited by law from diagnosing disease or offering definitive treatment.

Always consult with a qualified dental professional to ensure you receive the best care tailored to your specific condition.

— Cathye L. Smithwick, RDH MA, Silicon Valley Dental Hygienist