Options to resolve missing adult tooth

    Our daughter, now 13.5, was born missing her wisdom teeth and one of her rear adult bicuspids.  For now, the baby tooth remains in that place holding the space open. In the long run, leaving the baby tooth there will cause other issues, as would simply pulling it out. Her orthodontist is looking at two options: either replacing the tooth with an implant when she has finished growing; or remove both the baby tooth and the corresponding adult bicuspids in the other three quadrants of her mouth, and adjust the position of the remaining teeth to eliminate the gaps. He noted that implants can present problems, and indeed my husband's jaw more-or-less rejected an implant installed by a reputable guy -- we're waiting to see if the replacement implant works out.
    We plan on getting second opinions before proceeding, and none of the steps I've described would happen immediately. We're also interested in what folks at the receiving end of such treatments have experienced.  Has anybody out there had this type of problem or similar treatments?  Thanks!

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As an adult, due to a gum issue, they had to extract one of my molars (the one at the very rear).  We just left it open, it took a little getting used to, but has been fine.  I don't know if my age (middle aged) had anything to do with that decision. I also had an implant for a tooth that was between two other teeth, and that implant went fine.

I am missing one teeth too (as my dad did), I am 46 and still have my baby tooth! It's just recovered. I am not a dentist. But I would not remove it if it remains in place. You can protect the teeth by covering it and see what happens. 

I never got my lateral incisors (second teeth from the front on top) on either side as baby teeth or adult teeth. My parents had the option of moving my teeth forward or creating space and getting implants. I also had wisdom teeth that were going to come in impacted unless all of my teeth were moved forward. They decided to do the spacing and get implants for me (I may have contributed to the decision - can’t remember, I was in 6th grade). I got the implants at 17 and have had them for 15+ years now. No issues with them and it was the right decision. I ended up having all 4 wisdom teeth removed and the titanium implants implanted at the same time. It was a rough few days then but it got everything taken care of at once. 

I have the same "problem" with my teeth - missing wisdom teeth and one missing back upper molar. I'm 47 and this has never caused me any trouble whatsoever. I never had orthodontistry and I never had an implant. I was happy to be spared the expense of removing my wisdom teeth. Over the years, my dentists have noted the missing molar. I've even had a couple dentists suggest that I need an implant. These have been the same dentists who have tried to sell me other unneeded cosmetic services. My bite is not affected and the molar on my lower jaw opposite the missing tooth has not become overgrown (as one dentist warned), because it is partially overlapped. Unless your daughter is experiencing serious problems as a result of her missing molar, I would recommend that you wait a few years before you take any action. Maybe it will all work out fine as mine did.

I am 54 years old and I had a baby tooth in my mouth until about 5 years ago. The adult tooth never came in to push the baby tooth out. The baby tooth stayed put and kept my adult teeth aligned (I didn't ever have orthodontia, but I did have all four wisdom teeth pulled in my mid-20's). The roots of the baby tooth finally started to weaken and it felt a little bit sensitive/painful, so I had the tooth pulled and had an implant put in. The implant process was kind of expensive, even with dental insurance, but it went fine and I don't ever even think about the fact that it's there. But my larger point is that I didn't see any need to deal with the baby tooth until it started to bother me, when I waaay beyond my teen years!

Hello! I too am missing an adult bicuspid. Believe it or not, I was able to keep my baby tooth there until a few years ago, when I was 35 years old. I had a crown put on the baby tooth in my early 20s to keep it safe (& probably also served to keep the space adult-sized). Finally, at 35 I got an implant in it's place which I always knew was inevitable - I think the baby roots were starting to have issues - and for me personally the implant has been great (I was kind of afraid of it going in to it), but it sounds like your family has first hand experience otherwise with implants (I hope your husband's works out)). I could have gotten an implant a long time ago, but as mentioned I was a little reluctant to do so & none of the dentists/endodontists I saw over the years for various things seemed to think it was that big of a deal to push it out.

For the rest of my answer, disclosure that I am DEFINITELY not a dentist... but the option of removing all the other bicuspids seems extreme to me. For me personally I would err on the side of keeping/not disturbing as many of my real teeth if at all possible. My husband oddly is also missing an adult tooth, and he went the bridge route where they crown the (otherwise healthy) teeth on either side & suspend a fake tooth between, and I think he wishes he had an implant just b/c any issue with the bridge affects all of the teeth involved (I'm pretty sure he got this done before implants were as advanced/common as they are now).  (That being said, if a bridge ends up being her only option it certainly doesn't negatively impact his daily life or anything).

I’m now 37 and had the same issue (no wisdom teeth, one baby tooth with no adult behind it). My baby tooth lasted until I was in my late twenties when it basically fell apart while I was eating a coconut. At that point I had an implant put in. I’m so glad I didn’t do anything sooner and just let the tooth run it’s course. Good luck!

Not sure if this will help you, as I'm certainly not a dentist, but I can share my experience with my own teeth, as there are some similarities.

I never grew 3 of my adult teeth (both top lateral incisors and one wisdom) and it didn't cause any big issues for me. My baby teeth fell out gradually over a long period of time (through middle and high school) and the adult teeth came in gradually too. My dentists weren't concerned, at least back 20 years ago. I was told that some people just don't have all their adult teeth, and some people's grow in late. When I was 18 the last adult canine on the bottom row grew in without pushing the last baby tooth out, so I had to have that baby canine pulled to make room. I had the top baby canines pulled at the same time  and wore braces for a year to move the others round to fill the gaps for cosmetic reasons, and  in case there wasn't enough room when (or if) the wisdom teeth came out. Now, this was in Europe, where dental practices may be different, and people don't generally have as much dental work done. I also don't have perfect looking teeth, and don't know if I would have if we'd done things differently. But it doesn't bother me.

Aside from having pointier teeth near the front,  I never really noticed, and haven't had problems. In my 30s in SF, a dentist offered to add corners to the top canines to change the shape slightly to look more like the normal incisors which should have been there. I did that because it was free, and I do prefer it. 

A second opinion is often a good idea, particularly with dental work. 

I was also born missing my wisdom teeth and one of my lateral incisors.  As a teenager I got a bridge, which was basically a fake tooth with two metal flaps that were cemented onto the two surrounding teeth.  This lasted for about ten years until it broke one day when I bit into a piece of pizza.  I ended up getting a dental implant and I wish I had done it earlier!  It feels and looks like a real tooth, the process of getting it wasn't that bad, and I have never had any problems with it.  I know each dental situation is different, but wanted to share my story since I had a really great experience going the implant route.

My son had a similar issue at that age -- a missing adult molar.  We needed to make a decision about it prior to starting orthodontia.  We consulted with my dentist, who is very conservative.  He surprised everyone by suggesting that we pull the baby tooth and just close the space by moving the other rear molars forward.  When I asked him why, he said, "Because you're here," meaning that this was an opportunity to fix it forever and we should take it.  He was not concerned about there not being a partner in the lower jaw for the corresponding molar in the upper jaw.  

Now that my son is done with his braces, I am glad we did it this way.  It took longer in braces because of the gap that had to be closed, but it feels like a permanent solution.  My son has not had any problems relating to his bite.  And we avoided all those weird problems you have probably been warned about like the baby tooth fusing to the jaw and resulting in bone loss.  

I am not a dentist (obviously) but it is surprising to me that your daughter's dentist recommended removals in other quadrants of the mouth that don't have this issue.  

My final word of advice is that you should consult with a dentist who sees adults.  The pediatric dentist my kid had been seeing up to that point didn't really have the depth of experience needed to render an opinion.  You want to see a dentist who deals with full grown adults because those dentists know how these issues play out later in life.  Good luck with your decision!

Maybe, if you are able to wait long enough, she can grow her own new tooth using stem cells from the baby tooth.