An interesting but rare and often harmless condition is called eruption sequestrum (ES). This usually happens when new teeth, most commonly the first permanent molars, are coming in. Below, we’ll explain what eruption sequestrum is, its causes, symptoms, treatment options, and how to care for your child’s oral health.
Sequestrum of bone over six-year-old molars (also called eruption sequestrum, or ES) is an uncommon condition where a small fragment of calcified tissue, often bone, forms over the crown of an erupting permanent molar, typically the mandibular first molars in children around age 6. This fragment may appear as a firm, white bump on the gum where the molar is emerging. It’s a piece of calcified tissue (usually bone) that stays over the crown as the tooth erupts.
Dr. Culp gives this example, “When coral is taken out of the sea, the creatures that built the structure die, but the skeletal remains persist. In this case, the bone-forming cells died, and what’s left is their product - bone.”
In most cases, eruption sequestrum causes no symptoms and resolves on its own as the tooth fully erupts. The fragment is usually absorbed or is naturally dislodged without any intervention. Parents may notice it when their child points out a hard bump, or it may be spotted while brushing a child’s teeth or during a dental visit.
What Causes ES?
Eruption sequestrum occurs when permanent molars, especially the mandibular first molars, push through the gums. These teeth sometimes follow an ectopic (different than normal) path of eruption. If the molar’s cusps lie at just the right angle during the process of coming in, it can cause a small piece of bone to separate from the surrounding tissue. This fragment may remain over the erupting tooth, forming a visible bump. Most fragments are small and absorb before the tooth fully emerges, but larger fragments or slower eruption can lead to eruption sequestrum.
In rare cases, a different type of bony bump may form due to other causes, such as tooth extraction, trauma, or osteomyelitis, where a piece of bone protrudes through the gum. This is distinct from eruption sequestrum, which is specifically tied to erupting molars and not related to these other conditions.
Eruption sequestrum often presents no symptoms, and many children are unaware of the bump. When symptoms occur, they may include:
In rare cases, if the bump causes significant irritation, it may lead to swelling or redness. Persistent pain, ulcers, or signs of infection require prompt attention from a dentist. Parents should monitor the area and contact us if symptoms appear. Dr. Culp and our dental staff can assess the area, help your child feel more comfortable, and discuss this condition with you.
Dentists diagnose eruption sequestrum through a visual exam, often noticing a firm, white bump over the erupting molar. If needed, X-rays can confirm the presence of calcified tissue and rule out other issues. Regular dental checkups every six months allow early detection of such conditions, ensuring your child’s oral health is well-managed.
Most cases of eruption sequestrum require no treatment, as the bone piece typically resolves on its own as the molar fully erupts. If the fragment causes discomfort or persists, a dentist may recommend surgical removal under local anesthesia. This involves a small incision to remove the bony fragment, followed by smoothing the area and suturing the gum.
Post-treatment care includes following the dentist’s instructions, such as maintaining a soft diet and avoiding activities that could irritate the site. With proper care, healing is usually quick and complication-free.
As noted earlier, bony bumps caused by tooth extraction, trauma, or osteomyelitis are different from eruption sequestrum. These conditions may present with sharp protrusions, swelling, or infection and require different treatments.
While eruption sequestrum can’t be prevented, good oral hygiene supports healthy tooth eruption. A balanced diet rich in calcium and vitamins promotes strong teeth and bones. Regular dental visits to a trusted provider like Jungle Roots Dentistry ensure early identification of any issues, keeping your child’s smile healthy. As always, our staff can provide recommendations and interventions tailored to your young one’s ongoing dental well-being.
Eruption sequestrum over erupting 6-year molars is typically a harmless condition that often resolves without treatment. At Jungle Roots Dentistry, Dr. Culp and our team are here to provide expert care and guidance for your child’s dental needs.
We are privileged to help you protect your child’s oral health and maintain that beautiful smile!
