What should I do if my child’s permanent teeth are not erupting?

Under normal circumstances, permanent teeth typically erupt within 3 to 6 months after a child loses a primary tooth. However, the exact timing of eruption varies depending on the individual child’s physiological development. So what should parents do if a child’s permanent tooth fails to erupt? Below are answers to this common concern.

What to Do If a Child’s Permanent Tooth Fails to Erupt

1. Ensure Adequate Calcium Intake

If a child experiences prolonged delay in tooth eruption, it is advisable to increase dietary calcium intake through calcium-rich foods such as dried shrimp, milk, and fish soup. Additionally, regular sun exposure helps enhance calcium absorption. Since calcium is essential for tooth formation, appropriate calcium supplementation supports timely tooth eruption—and sufficient calcium contributes to stronger, healthier teeth.

2. Seek Professional Dental Evaluation

Parents are advised to take their child to a dental clinic for a panoramic radiograph (orthopantomogram). If the radiograph reveals absence of the permanent tooth germ at the expected site, no permanent tooth will ever erupt there, and prosthetic replacement (e.g., a dental bridge or implant) may be required. If the permanent tooth germ is present but has not yet penetrated the alveolar bone, gentle mechanical stimulation (e.g., chewing hard foods) may help promote its development. If the permanent tooth has already emerged into the alveolar bone but remains covered by gingival tissue, a minor surgical procedure—gingivectomy—may be performed to remove the overlying gum tissue and facilitate eruption.

Additional Information: Key Considerations During Children’s Tooth Transition

1. Maintain Good Oral Hygiene

During tooth development, teeth remain relatively fragile. Therefore, instilling lifelong oral hygiene habits early is crucial: children should brush their teeth twice daily (morning and night) and rinse thoroughly after meals.

2. Address Primary Tooth Caries Promptly

Before age five, dental caries most commonly affect the occlusal surfaces of primary teeth. During the transition period, inadequate cleaning allows plaque and debris to accumulate between teeth, increasing the risk of interproximal caries. Many parents mistakenly believe that since primary teeth will eventually be replaced, caries in them are unimportant. However, untreated primary tooth decay can adversely affect the development and alignment of permanent teeth—leading, for example, to malocclusion or crowding. Thus, prompt treatment of primary tooth caries is essential.

3. Monitor Permanent Tooth Eruption Closely

During the exfoliation phase, primary teeth normally loosen and shed spontaneously. Yet some children develop permanent teeth while their primary teeth remain firmly in place—causing permanent teeth to erupt ectopically (e.g., lingually or buccally), resulting in “shark teeth” (double rows of teeth). In such cases, timely extraction of the retained primary tooth by a dentist is necessary to prevent permanent tooth misalignment or occlusal abnormalities.

The above outlines key approaches when a child’s permanent tooth fails to erupt. We hope this information proves helpful.