How early loss of baby teeth can make orthodontic problems worse?

Tuesday, 10 Jul 2018 Andrew Chang 335 hits Print it

Early loss of a baby tooth. Is this a problem?

As an orthodontist practising in Blacktown, and serving the Blacktown, the Hills District, Quakers Hill, Rooty Hill, Mt Druitt, Minchinbury, Stanhope Gardens, Glenwood, Kellyville, Rouse Hill, Riverstone, Marsden Park, Schofields, Windsor and the surrounding suburbs, most parents are familiar of how sometimes a baby tooth that is very slow to fall out can affect the underlying adult tooth and its normal eruption.

What causes a baby tooth to be lost early? Would my child be in any pain when this happens?

However, many parents are not aware that early loss of a baby tooth can make orthodontic problems worse. Sometimes, your dentist may not be aware of what can happen when a baby tooth is lost early ie: due to teeth decay, or if it falls out just by itself, without any pain or discomfort being experienced by your child.

How early loss of a baby tooth can make orthodontic problems worse

It is also true that left undetected or unmanaged, the problem can progressively worsen and become more complex to treat later.

This blog would focus on the early loss of a baby tooth that happens without your child experiencing any pain, as this often progresses undetected. It is hoped by reading this blog, you would become more aware of your child’s teeth development and then become more proactive as a parent, as to when to see an orthodontist.

See the series of case studies below that illustrate how a baby tooth can be lost early by itself, without any pain or discomfort being experienced. At each stage, orthodontic treatment gets longer and more complex. At the final photo, are 2 adult teeth that are completely impacted, not able to erupt through the gums and needing surgical removal.

Case 1: Adult back molar erupting abnormally underneath baby tooth

This is usually the FIRST sign leading to early loss of a baby tooth

Early detection and management

Before

Smiles & Faces Orthodontics Blacktown

After 

Smiles & Faces Orthodontics BlacktownSmiles & Faces Orthodontics Blacktown

Orthodontic Treatment was very simple for this 7 year old and was over 6 months and required several visits of placing a temporary separating spring between his back molar. See the improvement in the back molar on the upper left side of his photo.

Case 2. Baby tooth had just been lost early

A bit later detection

In this case, we saw this 9 year old child later when she first presented to our practice, and the baby tooth had been lost. As you can see the space had already been lost with the back molar drifting forwards very quickly over the space of 6 months.

Before

Smiles & Faces Orthodontics

After

Smiles & Faces Orthodontics

Orthodontic treatment required an upper removable plate (see above), worn full time over a period of 12 months, which allowed us to regain this space. The underlying adult tooth eventually erupted.

Case 3. Both sides baby teeth have been lost early

Smiles & Faces orthodontics

As you can see on the left side of photo for this 10 year old, the baby tooth had now been lost early due to the adjacent back adult molar burrowing itself through underneath the baby molar. Note the space there is meant for a underlying adult side premolar tooth to erupt, half the space which had now been lost. The right side photo shows this actively happening.

Case 4. Late detection. Adult side teeth not able to erupt and impacted beneath the gums

Smiles & Faces OrthodonticsSmiles & Faces Orthodontics Blacktown

This is a 14 year old teen. The left side of the photo showed what looked like apparently uncrowded teeth, when there was a side premolar adult tooth that was completely impacted and unerupted (as you can see in her x-ray). The right side of the photo showed a side premolar tooth that had partly erupted through the gums, but was not able to come out further due to a lack of space. She eventually had to have both teeth surgically removed, under a general anaesthetic in hospital, and upper & lower braces to straighten her teeth and correct her bite.

In a series of future blogs, to improve awareness of what conditions can benefit from an early orthodontic assessment, I will illustrate how waiting can sometimes make an orthodontic treatment  problem become more complex and lengthy to treat later.

If you are in any doubt, seek the opinion of an orthodontist. Orthodontists are dentists whom have undergone an additional 3 years of specialty training to pick up and detect these issues, before they get worse.


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