The process of eruption of milk teeth is called teething. While teething follows a set pattern, it is not uncommon to see late teething in babies. The exact cause behind it is usually not always known. Nevertheless, most late teething cases are benign and do not need any intervention. Your pediatric dentist can help you rule out any other conditions that may require treatment. Read this post to learn more about the causes and complications of late teething and when to see a doctor for it.
Normal Teething Chart For Babies
It is essential to understand normal teething patterns in babies to determine delayed teething. The first teeth to erupt in your baby’s mouth are the lower front teeth, and they do so around six months of age. The upper front teeth are the next, followed by other teeth that emerge within their respective age range (1).
What Is Delayed Teething?
Teething is defined as the process of primary teeth eruption from the gums (2). If the teeth do not erupt during the usual age range or there is a significant deviation from their expected time of eruption, then the baby is considered to be experiencing delayed teething (3). Several signs and symptoms accompany the process of a tooth’s eruption. Babies with delayed tooth eruption also display delayed signs and symptoms of teething.
Should You Be Concerned If Your Baby Starts Teething Late?
According to the Australian Dental Association, some babies may begin teething at an early age of four months, while some may start teething as late as ten months (1). There is usually no need to be concerned if your baby experiences delayed teething. Each baby achieves developmental milestones at a different age, and it is the same with teething. A baby can achieve teeth eruption at any age within the specified age range. Therefore, you may wait since the baby could eventually experience teething on attaining the upper limit of the age range.
When To Consult A Doctor?
If your baby’s first teeth (lower central incisors) do not erupt even after the age of 12 months, see a pediatric dentist. Some babies are late bloomers and experience delayed teething for no specific reason. However, in some cases, delayed teething may occur due to underlying problems, which require diagnosis and treatment. Other developmental milestones may not be related to teething; thus, do not wait for your baby to achieve teething with other milestones before taking them to a dentist (4).
What Causes Late Teething In Babies?
The following conditions may cause delayed teething in babies. Some of the reasons are pathological abnormalities and may require treatment to commence teething.
1. Hereditary factors
If you or your partner had similar late teething issues at the same age, it could likely be that your baby experiences similar issues.
2. Poor nutrition
Studies have shown that low birth weight or poor nutritional status or nutritional insufficiency can affect teeth eruption. The nutritional status of the body influences teeth in their pre-eruptive phase. Any deficiency in calcium and the vitamins D, C, B, and A can significantly impact your baby’s teething (5).
3. Thyroid disorders
Babies with thyroid disorders, especially hypothyroidism, could have delayed teeth eruption. If they have any existing teeth, they may also have other dental problems, such as enamel hypoplasia, open-bites, or cross-bites (6).
4. Fibrosis
Fibrosis is a condition characterized by thick gums that impede or prevent the teeth from erupting. This could cause a delay in teeth eruption in some babies.
5. Hormonal issues
Problems in the secretion of the growth hormone, a hormone released by the pituitary gland, may significantly affect the development of facial structures, including the eruption of teeth. Hypopituitarism is one of the conditions that can cause the pituitary gland to secrete low levels of the growth hormone, leading to delayed teething, among other problems (7).
6. Systemic diseases and medication
Many systemic disorders, such as iron-deficiency anemia and sickle-cell anemia, may delay teething (8). Certain long-term medications may also interfere with tooth eruption.
7. Injuries
Any trauma to the jaw could affect the tooth buds and delay teething. Injuries may also lead to fibrosis, which also causes delayed teething.
8. Impacted teeth
Milk teeth may also become impacted like permanent teeth. An impacted milk tooth may fail to erupt and stay lodged within the jaw or gums. A baby with impacted teeth is likely to experience other signs and symptoms, such as gum redness, gum swelling, and pain.
9. Absent or missing teeth
In rare cases, a baby may have a missing tooth, which could be mistaken for delayed teething (9).
10. Genetic disorders
Genetic conditions, such as amelogenesis imperfect a and dentinogenesis imperfect a, may affect the baby’s teeth and gums, increasing the risk of delayed teething. Premature babies may also be at risk of experiencing delayed teething due to genetic reasons. Certain genetic disorders could affect the musculoskeletal growth of the body, affecting even the eruption of the teeth. Some genetic disorders associated with delayed teething are Down syndrome, Turner syndrome, Gardner syndrome, Hutchinson-Gilbert syndrome (Progeria), and Bloch–Sulzberger syndrome (10). A baby with these disorders is likely to experience other significant symptoms as well.
Complications Of Delayed Teething
Complications of delayed teething may depend on the underlying reason. Delayed teething due to no apparent reasons or due to benign reasons may not lead to complications. In some cases, delayed teething may cause the following complications.
