More Braces for Kids Whose Primary Teeth Are Slow to Erupt?

[Giovanni Castellucci, DMD]

Several genes affect tooth development in the first year of life, according to the findings of a study conducted at Imperial College London, the University of Bristol in the UK and the University of Oulu in Finland. The research, published February 26 in the open-access journal PLoS Genetics, shows that the teeth of babies with certain genetic variants tend to appear later and that these children have a lower number of teeth by age one. Additionally, those children whose teeth develop later are more likely to need orthodontic treatment. Abnormal tooth development may lead to dental problems that demand challenging and costly orthodontic treatment. The discovery of genes influencing tooth growth may lead to innovations in the early treatment and prevention of congenital dental and occlusion problems. Professor Marjo-Riitta Jarvelin said: "The discoveries of genetic and environmental determinants of human development will help us to understand the development of many disorders which appear later in life. We hope also that these discoveries will increase knowledge about why foetal growth seems to be such an important factor in the development of many chronic diseases." Do any of our orthodontic colleagues feel that this article has merit? Has this been your experience in practice?

Source: Science Daily
Journal Reference: Pillas D, Hoggart CJ, Evans DM, O'Reilly PF, Sipilä K, et al. Genome-Wide Association Study Reveals Multiple Loci Associated with Primary Tooth Development during Infancy. PLoS Genet, 6(2): e1000856 DOI: 10.1371/journal.pgen.1000856

[Ravi Kumar]

I think that this article has merit and the most difficult problem is to predict the direction and end result of growth. If we can do this then we can plan orthodontic treatment whether there is early or late eruption. Early or late eruption predisposes to certain malocclusion, but may not be the only or "the" most important factor. Personally I think there is a big problem with the term "normal". How do we determine a norm for anything. The organism and its environment is in a state of continuous evolution. So what was normal few centuries before may not be normal now! I am a fan of Phase II orthodontic treatment with fixed appliances and always advice my patients to wait for eruption of all permanent teeth before treatment unless there is a pressing need for early treatment (aesthetic?).

I have seen a secular trend in the early exfoliation of deciduous teeth and early eruption of permanent teeth (is it similar to the secular trend seen in early onset menarche?). Many studies have pointed to this direction. This may be due to increase carious involvement of deciduous teeth. I am treating a 10 year old boy with fixed orthodontics and he has all his permanent teeth in occlusion with the second molars erupting. So there is a trend in early treatment with fixed appliances now. The main factor I think is the changing food habits all over the world, leading to a reduced usage of teeth and masticatory muscles. This leads to increased incidence of malocclusion as opposed to the Attritional Occlusion of Australian Aborigines as documented by Dr. R.Begg.