By the time your child reaches about 3 years of age, he typically will have all of his primary teeth, but not always. Although delayed teething can be influenced by a variety of variables, a single cause is rarely determined. Occasionally, however, it can take up to 18 months before the first tooth erupts. If the appearance of the first tooth is not evident by that time, a trip to the pediatric dentist is warranted.
Delayed teething in toddlers can be caused by oral trauma, spacial issues of the mouth, systemic disease such as anemia and hypothyroidism, and genetic conditions. In addition, vitamin and mineral deficiencies, head and neck radiation and infections can also contribute to delayed teething in toddlers. Although not common, low birth weight, premature birth and babies diagnosed with failure to thrive syndrome can also be at risk for late stage tooth eruption. Delayed teething generally affects all teeth but can sometimes affect only a single tooth.
Effects of delayed teething in toddlers can lead to nutritional deficiencies, and cosmetic and functional problems. Spaces related to the absence of teeth can also make eating and speaking challenging. When a delay in the eruption of a couple of teeth occurs, teeth already exposed will shift, causing overcrowding in the mouth. As a result, a malocclusion, which is characterized by an uneven bite and possible pain, can develop.
Although delayed teething in toddlers is usually determined to be of a benign nature, systemic medical conditions need to be ruled out. If the pediatric dentist is unable to make a diagnosis, the child's pediatrician needs to further evaluate the condition. A series of diagnostic medical tests such a complete blood count and a serum chemistry profile will help the health care provider make a definitive diagnose for the delay in teething.
Treatment for delayed teething in toddlers depends upon the cause. If the cause is determined to be related to thyroid problems, thyroid replacement therapy will be indicated. Furthermore, if the absence of teething is the result of iron deficient anemia or other nutritional deficiencies, supplements or a change in diet will be in order. Structural problems can be treated by surgical intervention which will expose the yet unexposed teeth and spur tooth eruption. Whenever in doubt, parents need to consult with their health-care providers.