Children typically lose their last baby tooth around the time they are 12 years old. Quite often, the loss of a baby tooth is followed almost immediately by the appearance of its corresponding adult or permanent tooth.
If a baby tooth has been lost and a replacement permanent tooth does not appear in a reasonable amount of time, it could be because it is blocked, headed in wrong direction, or congenitally missing. The best way to determine what is going on is for the child to have a dental x-ray.
There are three possibilities when a child’s permanent tooth is absent:
These three options are not necessarily interchangeable, and the best choice is determined by other variables that include the actual condition of the teeth, the bite or the way the upper teeth relate with the lower teeth, and the amount of crowding or lack of space. A Certified Orthodontist is the dental professional best equipped to determine the next steps.
If the bite is good and there is no crowding, a good option is to often keep the baby tooth as long as possible and then replace the permanent one should the primary tooth fallout. If the baby tooth is in good condition, it may remain in place for a long time.
If it is in poor condition or if its root has been lost, the tooth can be replaced by an implant or a bridge. Trying to close a space orthodontically when there is no crowding and the bite is good is a long, difficult process that can introduce new problems as bad or worse than the original. The extended treatment time and the asymmetrical procedure can lead to uneven appearance as well as bone and gum problems.
If there is crowding or a bite issue that would require the removal of teeth anyway, removing the baby tooth and closing the space where the adult tooth is absent might be the best option. If there is crowding or the upper teeth stick out, it is not uncommon for upper bicuspids to be removed. If upper laterals or bicuspids are missing from birth, space can be closed leaving no need for a bridge or implants.
What is the most appropriate treatment for your child or yourself? A thorough examination by a Certified Orthodontist is the best way to find out. During the exam, your Certified Orthodontist will examine the alignment of the teeth, the amount of crowding, the bite and the jaw relationship and, go over the pros and cons of different approaches.
Are you concerned about your child’s dental development? Members of the Ottawa-Gatineau Orthodontists Alliance are here to help. Visit our handy directory of Orthodontists in Ottawa-Gatineau to find an office in your neighbourhood today.
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