This is either a case of gemination or fusion of the primary tooth. Both cases are very similar and basically what it means is that 2 teeth buds either did not split properly (gemination) or became fused (fusion) together during development. Although it is not extremely common (about 0.5% of the time in primary teeth), it is a noted deviation from the norm. It happens only about 0.1% of the time in permanent teeth, so the fact that it happened in your son's primary tooth does not necessarily mean it will occur with his permanent tooth which follows (or any other permanent teeth). It is most common in front teeth however, so your son's case sounds very typical. As far as the treatment goes, sometimes these cases cause the permanent tooth to have a delayed eruption, so the eruption pattern of his other teeth along with this particular tooth should be monitored closely by his dentist. It may need to be extracted at some point, or hopefully will exfoliate (fall out) in a normal pattern. The reason the tooth is discolored is most likely because the nerve in one of the canals (in gemination the tooth normally only has one canal in the root, and fusion normally has 2 seperate canals- which can likely be determined via xray) has died off. As in permanent teeth, when the nerve of a tooth dies (due to trauma, decay, or other causes such as an abnormal formation), the tooth normally will get darker. In adult teeth, this is cause for a root canal. In primary teeth, the tooth likely needs what's called a pulpotomy; which is like a root canal for primary teeth. This procedure however is much easier than a root canal on an adult tooth, but it both procedures require removing the nerve (or what's left of it) tissue and filling the canal space. After the pulpotomy, the tooth will likely need a crown. For primary teeth the crowns are normally prefitted and all of this can be done in one appointment. They also make crowns for primary teeth that look like natural teeth (instead of the silver ones they used to make), so that should make it look pretty normal. On the other hand, if he is only 2.5 yrs old, he definitely should see a pediatric dentist (specializes in seeing children), because it is very difficult to work on most 2.5 yr old children. Given his age, if he is not able to tolerate dental treatment at this time, the tooth can be left alone unless it becomes symptomatic (it probably will not) or until he is of an age where he can tolerate dental work. Leaving it for now should not cause any problems, but I would have it monitored by a pediatric dentist just the same. |
