The Dangers of Early Loss of Baby Teeth

Written by: Dr. Mai Kamar, Specialist Orthodontist

Our dental arches have been created in a harmonious manner where the baby teeth (milk teeth or primary) pave the way through the dental bones for a smooth and aligned eruption of permanent teeth. Any disruption in this harmony can create several problems that are well avoided by preserving healthy primary teeth for as long as possible till their natural exfoliation dates.

Inside the mouth of a growing child both primary and permanent dentitions are present, where one dentition is actually functioning and the other is still undergoing growth and development. Each tooth in the dental arch is maintained and stabilized in its correct position in the dental arch by the action of a series of forces. These forces are either from the neighboring or opposing teeth which support each other in the dental arch, or by forces from the muscles of the cheeks, lips and tongue, all of which maintain the teeth in the position they are currently at inside the mouth.

If these harmonious forces are disrupted or altered, one force starts to predominate and cause unfavorable movements to the teeth such as tipping or drifting which causes major problems in the permanent occlusion in the future. The number one cause of such disharmony is the premature extraction of baby teeth. Such extractions are either planned by the dentist when a tooth is severely decayed and cannot be saved by a dental restoration or decided by the parent who doesn’t believe in treating a baby tooth that will eventually fall out!

As a general rule when a primary tooth is lost prematurely, the following consequences usually occur:

• The teeth both on the right and the left to the extracted tooth move to close the space, hence the space designated for the permanent tooth that will erupt after a few years is lost and the tooth is blocked inside the bones.
• Delayed eruption or premature eruption of the permanent tooth
• Loss of the dental arch length which leaves less space for the proper eruption of permanent teeth and consequently causes crowding
• Relationship between the molars and canines is usually disrupted which more than often calls for treatment with braces
• Midline of the teeth shifts towards the extraction side
• Tooth opposing the extraction side usually elongates and overerupts
• Alteration in the overbite and overjet of teeth
• Development of abnormal muscle activity and habits such as tongue thrust in the newly created space or digit sucking, which create further disruption in the bite.
• Speech defects
• Poor nutrition and feeding
• Aesthetic and emotional problems

How to avoid such detrimental problems?

1. Regular dental check-ups.

The most recent guidelines by the American Academy of Pediatric Dentistry advocates that a child has his first dental visit as soon as the first tooth erupts or maximum at 12 months of age.

This allows a strong relation to be built between the Pediatric dentist, the parents and the child where healthy oral habits are established at an early age. Such relation, or as we call it a Dental Home, assures regular monitoring and close assessment of the child’s oral health and development, where cavities can be either prevented or detected at a very early stage. However, if parents fail to bring their children for dental check-ups, the child always ends up with unnoticed badly decayed teeth that often call for more comprehensive dental treatments such as root canals, crowns or even extraction of the tooth.

2. Better treat than sorry.

Always seek dental experts’ advice the soonest and when advised to restore a cavity, try to get it done the sooner the better. It is always best to have a simple restoration than a more extensive one! It will save your child the trouble of going through a more painful procedure and save you more money as well as have higher chances of saving the tooth itself!

3. Maintain the space.

If advised to remove a tooth always make sure that the dental specialist saves the space for the future permanent tooth by placing a custom made space maintainer in your child’s mouth in place of the extracted tooth.

4. Last but not least, maintain appropriate oral hygiene measures.

Brushing twice a day with a fluoridated toothpaste (indications differ by age of child), flossing daily and regular hygiene visits as well as low sugar diet are mandatory to keep dental decay at bay.

Stay healthy and have a lovely smile.