If you’ve been told that your child has an ankylosed tooth you may be wondering why it matters. Is it something that really needs treatment?
The tooth is fused to the bone, but so what?
Aren’t all your teeth attached to the bone?
How is this any different?
In some cases, an ankylosed tooth will be just fine without treatment.
Other cases, if left untreated, can result in some pretty major problems that will eventually require extensive treatment.
What is an ankylosed tooth?
In normal tooth anatomy, the root portion of a tooth is attached to the bone by collagen fibers that make up the periodontal membrane, also called the periodontal ligament. In contrast, an ankylosed tooth has fused directly to the bone, which means that the periodontal ligament no longer separates the tooth from the surrounding portion of the jawbone.
Normally, the periodontal ligament acts as a shock absorber and allows for a tiny bit of movement. It also keeps the tooth from fusing to the bone which is more important than you think.
Why is an ankylosed tooth a problem?
Many times, an ankylosed adult tooth can go completely unnoticed unless it needs dental restoration or will not move with braces. However, if the ankylosis occurs in a primary tooth or an erupting permanent tooth it may interfere with the proper development of the child’s mouth. An erupting permanent tooth will stop surfacing, causing it to sit much lower in the jaw than it should. An ankylosed baby tooth cannot move. So, it doesn’t get loose and fall out, which prevents the adult tooth from emerging.
Either of these situations can cause a variety of problems. The most common issue is malocclusion (poorly aligned teeth) that can negatively impact the function of the teeth. If the tooth is noticeably lower, it could make chewing difficult. All the surrounding teeth may not erupt into the correct position, the neighboring teeth can tip in toward the ankylosed tooth and are often more prone to developing cavities and periodontal disease.
Sometimes, the jaw may not develop normally. This can have a negative impact on the growth and development of the face and change its appearance. When the jaw is deformed and the teeth are misaligned, a person can also struggle with chewing, swallowing, and impaired speech.
Luckily, this condition is rare. Fewer than 200,000 people in the U.S. have been diagnosed with an ankylosed tooth. The biggest concern is that over 90% of ankylosed teeth are baby teeth, which have a high likelihood of negatively impacting the development of the mouth.
Causes and Prevention
There are a few main factors that are thought to cause an ankylosed tooth. Genetics and local metabolic changes play a major role.
Trauma to the tooth is another cause, which may result from injury, inflammation, or infection. While you cannot protect your child from everything that could possibly harm their teeth, you can protect their mouth from injury during sports. This is more important than you think since up to 39% of dental injuries are sport related. A sports mouthguard is an effective way to protect your child’s teeth and mouth and reduce the chance of developing an ankylosed tooth.
You can also help your child avoid inflammation and infection by helping them keep their mouth and teeth healthy. This starts with brushing every day once your child gets their first tooth. This is also the time to begin scheduling regular checkups to help keep their mouth healthy and identify potential issues before they become a problem. Most children will need help brushing and flossing until they are 6 or 7 years old.
Treatment will vary depending on many factors, including how much of the root is fused, which tooth is ankylosed, whether the tooth is a primary or permanent tooth, if it is causing the nearby teeth or jaw to develop incorrectly, and how much lower it sits in the jaw compared to other teeth. Here are a few possible treatments we may recommend.
If caught early, before more than 20% of the root has fused, it may be a relatively simple problem to fix. If your child has experienced any injury to the mouth, be sure to let us know at their next checkup. It will help us know to spend extra time looking specifically for this and other conditions that can be caused by injuries. As with any other dental condition, the earlier it is caught, the simpler treatment will be.
When the ankylosed tooth is a baby tooth, we will usually watch and see if the permanent tooth will erupt and force the baby tooth out. If this does not happen after a certain period of time, the affected tooth may need to be extracted to make room for permanent teeth to erupt.
An ankylosed tooth that is negatively influencing the development of the jaw or other teeth will often require orthodontic treatment. In this case, we will create a treatment plan that corrects the problem while bringing nearby teeth into optimal alignment and allowing the jaw to develop properly.
What if you discover a tooth is fused to the bone while getting braces? Will braces still be an option?
If the ankylosed tooth is a permanent tooth that does not sit too low in the jaw, you can still get braces. In some cases, it will be fine to leave the tooth where it is and move the other teeth into optimal alignment. If you cannot achieve a healthy, well-aligned bite while leaving the tooth where it is, we will help you determine the best treatment for the tooth.
Although this condition is rare, it is good to be aware of it. If you notice one of your child’s teeth are lower than the nearby teeth, or a baby tooth is not loose when it should be, be sure and let us know. We are privileged to help you keep your child’s mouth healthy and address any concerns you may have.
Call Us at (480) 759-1119
At Jungle Roots Children’s Dentistry & Orthodontics, we strive to provide the highest comprehensive pediatric and orthodontic dental care in a unique, fun-filled environment staffed by a team of caring, energetic professionals. We believe the establishment of a “dental home” at an early age is the key to a lifetime of positive visits to the dentist.
1. Alruwaithi, Moatazbellah & Jumah, Ahmad & Alsadoon, Sultana & Berri, Zeina & Alsaif, Miral. (2017). Tooth Ankylosis And its Orthodontic Implication. IOSR Journal of Dental and Medical Sciences. 16. 108-112. 10.9790/0853-160201108112.
2. Hadi, Aslan & Marius, Coval & Avi, Shemesh & Mariel, Webber & Galit, Birnboim-Blau. (2018). Ankylosed permanent teeth: incidence, etiology and guidelines for clinical management. Medical and Dental Research. 1. 10.15761/MDR.1000101.