Ectopic (abnormal) erupting adult 1st molars- why seeing an orthodontist by 7-9 years old is recommended.

Friday, 13 Sep 2019 Andrew Chang 11 hits Print it

Ectopic (abnormal) erupting adult 1st molars- why seeing an orthodontist by 7-9 years old is recommended.

What dentists need to look out for in 7-9 year old children

If you are a parent of children, an early orthodontic assessment for children from the age of 7-9 years can help detect and manage early crowding problems before they become more severe and difficult to treat. The topic of abnormally erupting adult 1st molars is one example of this, and where this problem can worsen with time.

Below is a podcast for dentists on this topic.

We welcome back kids dentist Dr Diane Tay where orthodontist Dr Andrew Chang and her discuss the topic of abnormally positioned adult 1st molars. This can often be seen in 7-9 year old children where an adult molar is taking a very long time to come down.

Highlights include:

0.50: How can dentists identify an ectopic permanent 1st molar?

3:00: Is the dentition (developing teeth and their eruption) appropriate for the age? Consider the general timing of eruption patterns and symmetry.

4:26: What are the causes of Ectopic adult 1st molars?

Most are mesioangular and usually they are upper teeth.Typical clinical presentation is described and almost always leads to space loss. The baby 2nd molar often can become loose and fall out without any pain.

7:20: If left unobserved, space loss can get more severe and lead to impaction of the underlying adult 2nd premolar.

8:00: No consistent pattern seen in causes. Look at OPG x-ray to check for age and symmetry.

10:00: Why dentists play a very important role in early detection of ectopic 1st molars, and early referral to a specialist orthodontist and how late detection makes orthodontic treatment longer and more complex.

11:30: What considerations to look out for when managing ectopic 1st molars.

– Age and Cooperation

– Occlusion. Is crowding present?

– Is it an upper or lower 1st molar?

-Is the permanent 2nd premolar present?

– Patient factors: Severity of impaction of molars. For

16:30- For mild impactions, can place elastic separator. For moderate to severe impactions, consider a metal separator, over a period of 3 months.

21:00- For severe 1st molars, upright these teeth first, using an expander or one with a Haltermann loop. If narrow jaw, combine with expansion.

24:30- Does disking of baby 2nd molars work?

26:00- Why close monitoring is needed, to monitor the ectopic 1st molar, and let the parent know what can happen if the child fails to attend final observation checks.

Dr Andrew Chang principal orthodontist of Smiles & Faces Orthodontics and his qualified caring team has been creating beautiful healthy smiles for the Western Sydney community over the past 10 years.


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