Wandering Eye Teeth

The eye tooth is a unique tooth.  The third tooth from the middle; it sits at the corner of the mouth and adds fullness to the lip.  It has the longest and strongest root, and it also travels the furthest when erupting into the mouth.  That explains why the eye tooth gets into the most trouble from an orthodontic point of view.

When all goes well, the permanent eye tooth erupts into your child’s mouth at age 11 or 12.  But, if the eye tooth wanders a few degrees off course, or if it hasn’t enough room to fit in, it can end up far away from the intended landing spot.  Think of it as the dental version of musical chairs.  Since the eye tooth comes into the mouth after the tooth on either side has found a place, it’s no wonder that it’s often sticking out like Dracula’s fangs.

Of course, that happens when the eye tooth tips toward the lip or cheek.  Often the eye tooth slips behind the other teeth and ends up impacted in the palate.  Impacted is a fancy word that just means it’s blocked, and has nowhere to go.

Why not leave it up there, and hold onto the baby tooth until your child has a job and their own dental insurance, or the Tooth Fairy comes for it?  Well, baby teeth don’t last forever.  Nature has programmed them to fall out, even when the replacement tooth is not pushing them out.  Secondly, the baby eye tooth is a poor substitute for the real thing.  It’s not as wide or as long as a permanent eye tooth.   It doesn’t fill out the lip as well, and so contributes to lines and wrinkles at the corner of the mouth.  Dermafill, anyone?  And this is the real problem.  Eye teeth don’t always sit quietly in your palate or under your nose.  Sometimes the enamel forming cells of the buried eye tooth start to swell, and become a cyst.  This cyst is not infected, but it grows, pushes on the roots of adjacent teeth, and destroys bone in the area.  It does all of this slowly, and painlessly.

What can be done?  Here are things to look for:

1.  If your child is a mouth breather or snores, chances are that the upper jaw will be narrow, and the eye teeth will be at risk.
2.  Check on your child’s lateral incisors (second from the middle).  They’re next to the two large central incisors.  If they seem to be tipping away from the central incisors, the wandering eye teeth may be pressing against their roots.
3.  Ask your middle school aged child if their baby eye teeth are getting loose.  Baby eye teeth that are firm may be a sign that the permanent eye teeth are not in the right place.
4.  Ask your dentist to check.  The eye teeth do not show in the bite wing x-rays dentists typically take at routine examinations.
5.  Call us and request an examination.  We may have some simple strategies to resolve, or at least improve the situation, even if your child is not ready for braces.  The initial examination is free, painless, and most children are mildly entertained.

Arthur Fertman, D.D.S.

Daniela Toro, D.M.D., M.S.D.