Mercy mercy, what a word! “Ectopic” is not as frightening as it seems at first glance, though. Not quite.
In medicine an ectopia is a displacement or malposition of an organ of the body. When it comes to teeth we mean a tooth that is coming into a poor position outside the arch formed by all its neighbors. My purpose in this post is partly to make parents aware that seeing a tooth coming in at an unusual position, like way up high in this image, is not a major cause for concern.
Teeth come into the mouth without any real road map, there is no genetically programmed direction to their path except a general “launch” kind of command programmed in. What guides them is, surprisingly, the cheeks and lips, the tongue, and their neighboring teeth. The muscle forces of eating and speaking tend to confine them to the center of the bone that holds them because those very muscle forces are centered over the bone contour. It all goes together like an outfit that meets with the approval of Stacy London.
What this means is that when we see a tooth coming in way up high and outside the rest of its friends, we can afford to observe it for a few months and see how things progress. Many times, it will settle in to a good position on its own.
There are a few reasons to be proactive with orthodontic movement of teeth like this, though. If a tooth has inadequate space among its neighbors, adequate space should be made with orthodontics as soon as possible so that it can come in without causing major crowding later on. Also the bone on the direct outer side of our teeth is very thin and does not have a lot of capacity for growth. If a tooth comes in too far outside the supporting bone, it may suffer recession later in life.
There are many causes of recession, but eruption too far outside the arch of teeth is one of the big concerns here. Sometimes only the contour of a tooth is visible under the gums and it just won’t come in. In these cases, it is best to expose the tooth with a small procedure and gain the ability to guide it in with orthodontics. Otherwise, it may hang there until the late teen years, causing appearance issues and crowding.
That’s the final potential reason to bring ectopic teeth into the arch- bling. If a young patient feels socially awkward because of their smile, it may be time to get the orthodontic hardware on with the elastics in the colors of the preferred sports team and get things done. At this point in the trajectory of our society, a nice smile doesn’t seem like a luxury anymore.