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Visitor asks:

Hello! I have two questions. I would like your opinion about hypodontia in a child. I have a 1.5-year-old daughter who is missing the upper lateral incisors. I read that if primary teeth are missing, there is a high probability that the permanent teeth are also missing. Is this true? During eruption of the remaining primary and permanent teeth, should we pay particular attention to anything? What are the subsequent procedures for treating excessively large and uneven gaps between teeth and differences in tooth heights? Can such irregularities lead to an abnormal bite? My second question concerns initial caries on permanent teeth. I have received two opinions and now do not know which is better. My dentist has been monitoring a couple of back teeth for more than 6 years where caries is in an initial stage. She says it is not worth drilling and thereby damaging the tooth if the caries is not progressing. She therefore checks these teeth at every six-month examination. During a chance visit to another dentist, however, he said that fillings should be made. I would like your opinion on the necessity of fillings when caries has remained in the same initial stage for several years. Thank you very much for your answer and kind regards, Maja.

Dentist Tomaž Rotar answers:

Dear Sir/Madam!

The probability that a permanent tooth is missing is indeed greater if its primary predecessor is already missing. You cannot influence this process yourself. The irregularity is corrected with an orthodontic appliance, most often when the complete permanent dentition is already present. After orthodontic treatment is completed, it is wisest to replace the missing tooth with a dental implant. Changes in tooth enamel that could represent caries and where it is difficult to decide whether they truly extend deeper or are merely a stained dental fissure are best monitored every six months.

Have a nice day!

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