Children s teeth attached to the gums or bone causes and complete treatment

Fused teeth to the gum or bone in children are a common issue that can cause delayed tooth eruption or misalignment in the jaw. If this condition is not detected and treated early, it may lead to problems with chewing, bite, and even the eruption of permanent teeth. In this article from Dalily Medical, we will explore the causes of fused teeth in children, their symptoms, diagnostic methods, and the best treatment options, whether through observation or surgical intervention, to help you, as a parent, protect your child’s oral health and ensure proper dental development.

Fused Teeth in Children: Everything Parents Need to Know

1. What are fused teeth in children?

Fused teeth are teeth that are attached to the gum or bone instead of moving naturally. This prevents them from erupting at their normal time.

2. Do all fused teeth require surgery?

No. Some cases can be monitored without intervention if the tooth is partially visible and not causing problems.
Surgical intervention is usually for advanced cases or to prevent issues with permanent teeth and bite alignment.

3. Risks of untreated fused teeth:

Delayed eruption of permanent teeth.
Crowding or abnormal gaps between teeth.
Problems with chewing and bite alignment.
Gum inflammation or decay in adjacent teeth.

4. How to care for a child’s fused teeth:

Brush teeth and gums gently with a soft toothbrush.
Use child-friendly toothpaste.
Regular dental check-ups to monitor changes.

5. When to see the dentist immediately:

If the tooth hasn’t erupted by its normal age.
Persistent pain or sensitivity.
If the fused tooth affects tooth alignment or chewing.

6. Frequently Asked Questions About Fused Teeth

Does it affect the appearance of the mouth or smile?
Yes, especially the front teeth, as it may cause gaps or uneven tooth heights.

Can the fused tooth disappear on its own?
Rarely, if the fusion is partial, but most cases require monitoring or treatment.

Is the fused tooth painful for the child?
Sometimes it causes mild sensitivity or discomfort while chewing or if there is gum inflammation.

Does it affect the eruption of permanent teeth?
Yes, a fused primary tooth can prevent the permanent tooth underneath from erupting.

Does surgical intervention affect the child?
The procedure is usually simple. Dentists take precautions to minimize pain, and recovery is generally quick.

Does the child need braces after treatment?
Sometimes a minor orthodontic treatment is needed if the fused tooth affected the alignment or bite.

Do fused back teeth affect chewing?
Yes, they may cause difficulty or pain during chewing if they are in an abnormal position or completely fused.

Can fused teeth be prevented?
Not always, especially if the cause is hereditary or congenital.
Early dental check-ups help detect fused teeth early and reduce complications.

Are fused teeth dangerous?
Generally, no. But untreated cases can lead to:

Misalignment of teeth and bite.
Abnormal gaps between teeth.
Complications requiring later treatment.

Do all children need X-rays to monitor fused teeth?
No, only children with:

Delayed tooth eruption, or
Clear signs of tooth fusion
may need X-rays for confirmation.

Stages of Fused Teeth in Children

Early Stage

Tooth is in the initial eruption phase.
May be partially visible or not visible at all.
Fusion to the bone is usually partial.
The child often has no significant symptoms.

Partial Emergence Stage

Tooth is partially visible on the gum.
Fusion prevents it from reaching the level of adjacent teeth.
Gaps or uneven tooth heights may appear.
Mild sensitivity or discomfort while chewing may occur.

Complete Ankylosis Stage

Tooth is fully fused to the bone, barely visible or not at all.
May prevent the permanent tooth beneath from erupting.
Adjacent teeth may shift to compensate, causing crowding or bite issues.

Complication Stage

Untreated fused teeth can lead to:
- Misalignment of teeth and jaw.
- Abnormal gaps between teeth.
- Problems with chewing or bite.
- Need for surgical or orthodontic intervention later.

Causes of Fused Teeth in Children

Genetic factors: Some children have a hereditary predisposition to tooth-bone fusion.
Trauma to the tooth or gums: Any injury to a primary tooth may cause it to fuse with the bone.
Abnormal tooth or bone formation: Irregular development can result in fusion.
Repeated infections: Gum infections around the tooth can affect tissues and cause fusion.
Decay or loss of adjacent teeth: Alters pressure on neighboring teeth, increasing the risk of fusion.
Jaw growth abnormalities: Misalignment or irregular jaw development may contribute to tooth-bone fusion.

Symptoms of Fused Teeth in Children

Delayed tooth eruption: Tooth doesn’t appear at the normal time or erupts later than others.
Uneven tooth height: Fused tooth may be lower or partially visible.
Gaps between teeth: Unusual spaces may form between adjacent teeth.
Difficulty chewing or biting: Pain or discomfort if the tooth is in an abnormal position.
Shifting of adjacent teeth: Neighboring teeth move to compensate, causing crowding or misalignment.
Gum sensitivity or mild pain: Occasionally around the fused tooth.
Permanent tooth eruption blocked: The primary fused tooth may prevent the permanent tooth underneath from emerging, visible on X-rays.

Types of Fused Teeth in Children

By degree of fusion:

Partial Ankylosis: Part of the tooth fused, part free; may appear partially on the gum.
Complete Ankylosis: Entire tooth fused; barely visible or not visible at all.

By location:

Front teeth: Usually lower incisors, may cause gaps or uneven tooth levels.
Back teeth (molars or premolars): May affect permanent tooth development and bite alignment.

By eruption status:

Completely missing: Not visible on the gum.
Partially visible: Part of the tooth visible, part fused to the bone.

Impact on Permanent Teeth

Prevents permanent tooth eruption: The fused primary tooth can block the permanent tooth beneath from emerging.
No effect on permanent teeth: The tooth is present but does not significantly affect the development of the permanent teeth.

Risks of Fused Teeth in Children

Delayed eruption of permanent teeth: The permanent tooth may not appear at its normal time.
Crowding or misalignment: Adjacent teeth may shift to compensate for the fused tooth.
Bite and chewing problems: Fused teeth can cause pain or difficulty while eating.
Wear on adjacent teeth: Pressure on neighboring teeth may lead to wear or weakening.
Gum inflammation or infection: Food debris accumulation around the fused tooth increases the risk of inflammation.
Need for complex treatment: If left untreated, the child may require surgical or orthodontic intervention later.

Diagnosis of Fused Teeth in Children

Clinical Examination:

Assess whether the tooth is fully or partially visible.
Observe differences in height compared to adjacent teeth and abnormal gaps.
Fused teeth are usually immobile.

X-rays:

Detect whether the tooth is partially or fully fused to the bone.
Show the location of the permanent tooth beneath the primary tooth.
Determine if the fused tooth is blocking the eruption of permanent teeth.

Mobility Test:

Normal teeth move slightly under gentle pressure.
Fused teeth remain completely immobile, which is a key diagnostic sign.

Medical History and Past Injuries:

Dentist checks for trauma or injuries to the tooth or jaw.
Investigates genetic conditions or repeated infections.

Monitoring Growth and Development:

Sometimes the dentist follows the child for several months to see if the tooth will erupt or remain fused, especially if partially visible without major complications.

Surgical Treatment of Fused Teeth in Children

Surgical treatment depends on the degree of fusion and type of tooth, and the method is chosen to ensure normal tooth eruption and proper dental alignment.

1. Partial Ankylosis

Condition: Tooth partially visible; limited fusion to the bone.
Surgical Approach:
- Lift the gum or remove part of the bone to allow natural eruption.
- Sometimes orthodontic forces are applied afterward to guide the tooth.
Goal: Allow normal eruption without affecting adjacent teeth.

2. Complete Ankylosis

Condition: Tooth fully fused; barely visible or not visible.
Surgical Approach:
- Extract the fused tooth if it blocks the permanent tooth.
- The space may be left for the permanent tooth to erupt naturally or orthodontic treatment may follow.
Goal: Prevent bite problems and crowding.

3. Fused Front Teeth

Condition: Affects smile aesthetics and creates gaps in front teeth.
Surgical Approach:
- Remove surrounding bone to allow eruption.
- Extract if it blocks the permanent tooth.
Follow-up: Usually minor orthodontic treatment is needed to adjust front teeth alignment.

4. Fused Back Teeth (Molars or Premolars)

Condition: Can cause chewing and bite issues.
Surgical Approach:
- Remove bone around the tooth or extract depending on fusion severity.
- Sometimes orthodontic intervention is required afterward.

Management of Fused Teeth in Children

Management depends on the degree of fusion and condition of the tooth. The main approaches are:

1. Observation

Suitable for partially visible teeth without major problems.
Dentist conducts regular check-ups and X-rays to monitor permanent tooth eruption.
Goal: Intervene only if the situation changes or permanent teeth are delayed.

2. Orthodontic Intervention

For partially fused teeth or irregular eruption.
Light orthodontic appliances help guide the tooth to erupt properly.
Sometimes combined with minor bone or gum removal.

3. Surgical Treatment

For advanced cases: fully fused teeth or those blocking permanent tooth eruption.
Procedures:
- Remove bone around the tooth.
- Extract the fused tooth if necessary to prevent bite issues.
Post-surgery, orthodontic follow-up may be required to adjust dental alignment.

4. Gum and Tooth Care

Brush teeth and gums thoroughly to reduce the risk of inflammation or decay.
Use a soft toothbrush and child-friendly toothpaste.

5. Regular Monitoring and Follow-up

All fused teeth cases require regular dental visits to check:
- Permanent tooth eruption.
- Any changes in alignment or bite.
Goal: Early intervention minimizes crowding, abnormal gaps, and future complications.