Teeth (extracting)

Two bottom teeth erupted first followed by her molars, eye teeth, and now, her top tooth on the right is coming in. The other hasn’t come through. Is age a factor? She will be two years old soon.

This situation is a common one. Children with CdLS usually find their primary or baby teeth erupting slightly later than one would expect. The routine pattern of eruption of the baby teeth is:

• The lower two central teeth in the front.
• The upper two central teeth in the front.
• The lower incisors next to the lower central teeth.
• The upper incisors next to the upper central teeth.
• The lower first molar then the upper first molar.
• Then the “eye” teeth or cuspids at the corner of the mouth.
• At 2 1/2 to 3 years we see the second molars arrive on the lower and then upper back jaws.

With CdLS we find that the timing for the presence of the teeth can be off by as much as one to one and a half years. The sequence of the teeth erupting can also be off a bit due to the small jaws and slower overall growth of the child. Sometimes the order in which teeth erupt can be altered by any condition or syndrome that has with it small jaws and craniofacial distortions. Molars coming in before front teeth is common.

There is not much to worry about. The teeth will eventually come in. The required space needed for the teeth to line themselves up properly may become an issue as time goes on. The children are often small in stature and this smaller growth is reflected in the mouth as well as in the rest of the body.

There can also be missing teeth as well as extra teeth. An early visit to the pediatric dentist will assure the proper monitoring of each child’s specific situation. The first visit is recommended at 12 months or when first tooth comes into the mouth. Sounds early but the information gained at the early visit will alleviate future fears, concerns and issues.

RM/TK 7-13-10

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