This 22-year old young man had come to me with some dental problem. On oral examination i noticed one of his milk tooth (upper canine 0n his left side — indicated by an arrow in the dental photograph given below) is still retained in the mouth.
Here you are looking at the dental photograph of this patient. Look at the healthy gums showing stippling with scalooped margins -he had come for pain in some other tooth. Regarding this tooth he was not sure –just told me that it is black and looks quite shabby.
You can see in the dental x-ray also that the root of this tooth is considerably resorbed (“eaten away”) –that’s perfectly ok but the problem is that this tooth never shed off. Most of the times when a permanent tooth is missing, the milk tooth lying above it fails to fall off naturally. In this case also since upper lateral incisor (front tooth) is missing — its place was taken by the permanent canine and this milk tooth has been ‘retained’. This man has got no problem in this milk tooth, he is eating normally and this milk tooth has not troubled him anytime. The milk tooth is not shaky at present.
Once he came to know that the tooth is a temporary tooth, he got quite anxious to know how long it would stay in the mouth. I told him that nothing can be said with certainty but i have seen a 65-year old man with such retained teeth. He felt a bit relaxed.
Now coming to the various treatment options available for this retained milk tooth. One, this milk tooth can be removed and later on he can be asked to get a fixed partial denture in its place (‘dental bridge). Even he can be asked to get a removable artificial denture to cover up the empty space which would be created after the removal of this milk tooth. Even he can be advised to get a dental implant after removal of the milk tooth. Cursorily i suggested all these options to him. However, i was myself not in favour of any of these options at 22years since his overall oral health is otherwise excellent. I couldn’t justify the thought of removing his milk tooth and then going for artificial tooth.
I suggested to him that we need to do some treatment involving root canal of that milk tooth after which a tooth-colored material known as light-cure composite can be used to build it up to make it appear a bit bigger and whiter which would hopefully blend well with adjacent natural teeth. He agreed in spite of being clearly told that it is not sure how long this milk tooth would survive in view of its resorbed root and that it is just a hit and trial case.