KEEPING
Baby teeth play 2 very important roles :
- As a space maintainer for permanent teeth
- As a bone growth stimulus for surrounding bone
Without tooth, there is no function therefore no growth. Dentists and orthodontists tend to maintain bone growth as long possible until normal falling out date.
Often around 7-8, permanent front teeth get crowded when coming out. It is completely normal: permanent teeth come out on a child jaw. With growth, things improve naturally until next eruption of permanent teeth around 11-12.
We highly do not recommend removing baby tooth sitting next to lack of space if we want to keep all permanent teeth later on. It would only worsen the lack of space problem trying to free some momentarily. We would then enter into a teeth extraction spiral looking for space up to removal of permanent teeth.
Because the more we remove teeth, the more we block growth ( this “planned extractions technic” tends to disappear).
As a reminder for baby teeth falling average age, here are 2 figures easy to remember :
- 8 teeth fall at 8 and are replaced in front (incisors). In fact there are 4 more permanent teeth, already erupted at age 6.
- 12 baby teeth fall by the age of 12.
But things do not alway occur in an harmonious way in nature.
Mechanisms, yet relatively unknown, with baby teeth resorption and with permanent teeth eruption can show certain anomalies.
REMOVING
1-In case baby tooth gets infected, there is infectious risk for permanent tooth germ underneath, and if it baby tooth can’t be treated, it should be removed.
2 –In case baby tooth keeps in place and forces permanent tooth erupt towards a wrong place.
3 –In case permanent tooth decides to change its way out and takes another tooth’s place or simply stays inside the bone.
There’s also some family tendencies whereby baby teeth never fall naturally and need intervention. Eruption processes are quite complex.
We, as orthodontists, advise our patients to come and consult us for a free visit once a year so as to follow up as best as possible each child teeth eruption. As long as the last permanent tooth hasn’t erupted, it is impossible to say whether a treatment will be useful or not. Upper canines may remain impacted and are often detected late at 16 or being an adult, when one does not want to undergo a treatment and when the Social Security doesn’t reimburse anymore. Persistence of a baby tooth beyond 12 must be looked upon.
Conversely,, when a tooth falls out too early or must be extracted before normal falling date, growth gets blocked, underneath germ may remain blocked in its eruption and chewing disorganised on that side.
KEEPING SPACE for absent baby teeth?
Pediatric dentists (dentists specialised in children) advise maintaining baby tooth space.
Orthodontists are less interventionists and prefer letting the space close itself partially because having a space maintainer requires upkeep and a regular follow-up for several years, consuming patient’s compliance. Yet this one will be very important further on for next orthodontic treatment, necessary in any case!
Stay confident: putting in place a retained tooth doesn’t require more than 6 months treatment. So no need to bother for years with a space maintainer.
KEEP AN EYE
So we advise parents to regularly keep an eye on their child’s teeth and watch out 2 essential phenomenons :
- In case erupting permanent tooth is lining up aside baby tooth: consult as quickly as possible general dentist to remove baby tooth which doesn’t give way on due time
- Consulting an orthodontist at least around 12 to check if teeth eruption is correct and eventually detect any impacted tooth.
IN BRIEF
Baby teeth should be removed :
- only at normal falling out age, 8 for incisors and 12 other teeth (premolars and cuspids).
- only if they prevent permanent teeth eruption trying to break through.
We advise to get an orthodontist’s opinion not to miss out on something.
EXCEPTION
For patients with late dental eruption, and not to achieve late treatment with demotivated patient, orthodontist might decide to remove one or 2 last remaining baby teeth. Although decision making has to be balanced between on one side patient compliance and treatment success and on the other side intervention on nature.
This website gives access to general information about orthodontic treatments. It is not meant to replace personal patient / practitioner relationship that you will get in our clinic.