Author Name: Dr. Sandra Thompson
A Dilacerated Tooth in Children refers to the presence of a tooth that has formed with a bent or a curved structure of either the crown – which is the visible part of the tooth – or the root that is located under the gums. This unusual formation is present from the time the tooth grows and can alter its eruption or function as well as its alignment with other teeth.
Even though dilacerated teeth are not very common, they usually get diagnosed when a permanent tooth does not grow correctly or when it grows in an unusual place in a child or teenager. There are some children who do not experience any problems and whose condition becomes evident in regular X-rays performed in a dentist’s office.
Dilacerated teeth are not merely crooked but actually have a different shape because of the unusual curvature of the tooth. This abnormality makes it challenging for the tooth to erupt or will create difficulty later on in orthodontic treatment. Since the curve is situated below the gum line, it cannot be detected by a visual inspection.
Dental X-rays are usually recommended by pediatric dentists when there is any delay in eruption of the permanent teeth or when they appear to be impacted or are developing in a way that is different from the adjacent teeth.
Dilacerated Teeth in Children occur when a tooth deviates from its usual path while developing under the gumline. Although the cause is not usually known, there are several reasons that can lead to such teeth. It is useful for parents to know about these reasons in order to know when a dental examination will be useful.
One of the primary reasons for a permanent tooth to become dilacerated is due to trauma to the baby tooth. An accidental fall, a sports accident, or trauma to the mouth might affect the development of the permanent tooth under the baby tooth. Should the developing bud of the tooth become displaced during the process of healing, the permanent tooth will grow abnormally and curve, giving rise to a curved crown or root.
The good news is that all injuries to the tooth do not result in dilaceration. However, for those individuals who have suffered severe trauma to their front teeth, it is important for them to continue visiting their dentist regularly.
Permanent teeth start developing years before eruption in the oral cavity. In case of disturbance of the development of the tooth, there can be changes in the natural process of its development. Despite the injury being suffered in the early stages of life, the changes may become apparent only at the time of eruption of the permanent tooth.
However, dilaceration can develop in some cases despite no obvious physical injury having taken place. This is because there are certain developmental factors that may contribute towards a deviation of the formation of the tooth irrespective of whether it has been damaged or not.
Sometimes, when the eruption process of a tooth becomes delayed, the condition can also be caused by dilaceration of the tooth. Even though delayed eruption does not necessarily point out to any complication, the extended delay needs to be checked through the use of dental X-ray films.
Sometimes, the tissues that produce the tooth grow in an abnormal manner. This may cause the crown to become curved or bent, or lead to a misplacement of the tooth. This kind of development defect is usually detected through dental imaging procedures.
Limited space in the mouth can exert more pressure on the emerging teeth. Crowding itself does not cause dilaceration but can make matters difficult during eruption when the tooth has an irregular curvature. The condition can be assessed by a pediatric dentist or orthodontist.
Since most of these reasons arise much earlier than when the permanent tooth erupts, the parents do not have any idea that their child has a dental problem. It is important to carry out routine dental checks along with age-appropriate X-rays to keep track of the dental developments.
Most kids who have the condition of Dilacerated Tooth in Children suffer from very little or no symptoms at all until the development of teeth begins. In actual fact, this disease is diagnosed through regular dental X-rays due to the non-emergence of the permanent tooth. There are also some symptoms that parents need to look out for in their kids.
The most prevalent symptom is that a tooth remains unerupted after the period that would have been considered appropriate for the eruption process. Even though eruption times vary from one kid to another, a delay might be an indication that the tooth cannot erupt as expected because of its curving.
The tooth will emerge at an unusual angle as compared to other teeth and may even appear rotated. Depending on the extent of the curvature, the tooth will either erupt partially or completely under the gum line.
Since the involved tooth might not follow the usual eruption pathway, it can cause problems like crowding or misalignment, which will have a bearing on the child's bite.
In case of difficulty in the eruption of the tooth, there may be irritation in the gum tissue. Not all kids experience pain in their mouth. However, any swelling should be investigated by the p
Some children may complain of pain during chewing and sensitivity around the tooth due to pressure under the gums or improper eruption of the tooth.
The tooth emerging from the wrong place can disturb how the top and bottom teeth relate to one another. The parents may observe that their child is biting in an unusual manner or experiencing difficulties while chewing on particular teeth.
The more uncommon case of crown deformities results in the outward appearance of the tooth being bent or distorted. More frequently, however, the distortion occurs in the root of the tooth, not the crown, and thus can only be detected through dental imaging.
There are instances when a baby tooth comes out on its own without the permanent tooth replacing it. Even though there may be various dental problems responsible for this phenomenon, dilaceration could be a potential issue.
Parents often wonder whether a delayed tooth is simply developing slowly or if something more serious is happening. A pediatric dentist can distinguish between several possibilities:
Normal eruption delay: The tooth is developing normally but taking slightly longer to appear.
Impacted tooth: The tooth is blocked by bone, gum tissue, or another tooth.
Missing tooth (congenitally absent): The permanent tooth never developed.
Dilacerated tooth: The tooth has an abnormal bend in the crown or root that interferes with its normal eruption.
Treatment of Dilacerated Tooth in Children depends on a variety of factors, such as the age of the child, the position of the tooth, the extent of curvature, the eruption of the tooth, and the presence of any pain or dental issues. Not all children need to be treated immediately, although some may need treatment in order to save the tooth.
Some milder cases might not need treatment other than simple monitoring. Your pediatric dentist will look at the health of your child's teeth every time you visit and take X-rays periodically to see how well the tooth is growing and erupting.
Dental radiographs play an important role in the diagnosis of a dilacerated tooth and in determining a treatment plan. They help the dentist to track root development and the direction of growth of the tooth. In most cases, close observation helps in establishing whether there is an immediate need for treatment.
When the tooth is growing out of its mouth in an unusual way or causing crowded teeth or malocclusion, then orthodontic intervention may be needed. The orthodontist will assess whether the braces or other devices could be helpful.
Where the part of the tooth that shows when you smile is affected, procedures like bonding or crowns can help to make the tooth look better. It all depends on how much tooth structure is left intact.
Some dilacerated teeth will be found under the gum line. In such cases, a surgical exposure of the teeth can be done by an oral surgeon or a dentist specializing in children’s teeth in order for orthodontics to align the teeth.
Should the tooth fail to erupt well, suffer from excessive curvature in the roots, or have difficulty functioning, extraction may prove to be the most prudent course of action. The pediatric dentist will talk to you about your replacement options.
Depending on the complexity of the case, your child may be referred to:
A pediatric dentist for diagnosis and ongoing monitoring
An orthodontist for eruption guidance and bite correction
An oral surgeon if surgical treatment is required
Identification of a dilacerated tooth as early as possible means having more options for dealing with it. Regular dental checks and taking of X-rays can ensure that any difficulties will be discovered before they become hard to handle.
When parents observe any indication that their children’s permanent teeth are not developing properly, then it is time for them to take them to a dental examination. Although children have different paces when it comes to oral development, they should not overlook these delays as they can lead to more severe issues. A pediatric dentist will determine the reasons behind the problem and find the right solution for it.
No. The problem of dilaceration lies in the formation of an abnormal curve in the tooth. Although there are cases of self-repairing of the tooth, the curve itself remains unchanged.
Is a dilacerated tooth the result of trauma to my child's mouth during childhood?
Yes and no. Often trauma to the baby teeth results in the problem with their permanent substitutes; however, there may be other reasons for dilaceration such as genetics or the peculiarities of teeth growth.
During a regular visit to a pediatric dentist, they will diagnose the condition with help of examination and X-ray pictures.
No. In many cases, the patient needs to have only regular X-rays taken in order to monitor the development of the dilacerated tooth.
Yes. An abnormal form of the tooth makes the orthodontist's task more difficult.
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