Idol Smiles, Miami, Orthodontist, Dr. Derek Sanders, Invisalign, Braces, Coral Gables, South Miami, iPad, ContestDollar signs may replace the stars a child sees after getting a tooth knocked out on the playground when he realizes he’s earned another visit from the Tooth Fairy.

But losing baby teeth prematurely is a serious matter. Those baby teeth play a significant role in children’s oral development. A baby tooth lost too soon can present orthodontic difficulties in the future.

The Importance of Baby Teeth in Early Development

Keeping your child’s baby teeth healthy and doing all you can to keep them in place until they are ready to fall out naturally sets the stage for a lifetime of good oral health. Baby teeth are necessary for a child to foster good nutrition through proper chewing. They also aid in speech development.

Normal tooth loss begins around age 6 for most children and is complete by about age 12. The baby teeth tend to naturally fall out in the order in which they erupted. The roots break down through a process called resorption as the permanent teeth push against them. A lost baby tooth is replaced by its permanent counterpart over the course of a few weeks.

This is an important process because the baby teeth serve as space holders for the adult teeth by remaining in place until the adult teeth are ready to erupt. Losing one or more baby teeth early due to being accidently knocked out or removed by the dentist due to disease leaves a space that isn’t quite ready to be filled. It’s important to consult an orthodontist in these situations to determine if interceptive treatment is necessary to prevent more complicated orthodontic challenges later in childhood.

Typically, the space left by a prematurely lost baby tooth must be saved, but this depends on the child’s age and location of the tooth. We do this by inserting a space maintainer to take the place of the baby tooth until the permanent tooth is ready to emerge. This stops the neighboring teeth from tipping or drifting into the vacant space.

Allowing the other teeth to encroach upon the empty space may not leave enough room for the permanent tooth, which could cause it to erupt outside of its proper position. This can create a domino effect by interfering with the positioning of other teeth and causing crowding.

Teeth that are crowded and out of alignment are more difficult to clean and are at increased risk of cavities.

Other Causes of Premature Tooth Loss

Although they are less common, there are additional causes of premature tooth loss unrelated to trauma or decay. Generally speaking, you should consult an orthodontist if your child loses any teeth before age 4 to determine whether any inherent dental problems have developed.

Diseases that are associated with early tooth loss in children include:

  • Immunological problems associated with the ability to ward off infections
  • Metabolic disorders
  • Blood diseases
  • Defective cellular enzymes

Some children have difficulty fighting infections due to compromised natural defense systems, according to

Defective chemotaxis- is a condition that suppresses white blood cell movement. This can lead to periodontitis, or gum disease, which can result in premature tooth loss. Periodontitis is an inflammatory disease that adversely affects the tissues that support the teeth.

Another problem with the natural defense system is abnormal adhesion of white blood cells, which prevents them from fighting infection. This also can lead to periodontitis in young children.

Diabetes– Children who have poorly controlled diabetes are at increased risk of developing gum disease due to impaired neutrophil function, microvascular abnormalities, and altered collagen metabolism.

Hypophosphatasia– Seventy-five percent of children who have this rare genetic disease lose all of their baby teeth prematurely. It is caused by low levels of serum alkaline phosphatase, which damages the ligaments responsible for holding the teeth in place.

Neutropenia– This blood-related disease causes a decrease in or the absence of neutrophil cells, which help fight bacterial infections. Children who have neutropenia often have periodontal infections and experience early tooth loss.

Leukemia– Malignant white blood cells can invade the gum tissue, and cause the gums to bleed and teeth to become loose.

Papillon-Lefèvre disease– Children with this rare disease lack an enzyme called cathepsin C, which causes periodontitis and the premature loss of baby and adult teeth.

What Problems are Associated with Late Tooth Loss?

Just as losing baby teeth too soon can lead to orthodontic issues, losing them too late can have a similar effect.

We follow the American Association of Orthodontists recommendation that children be evaluated by an orthodontist at age 7. This is a good age because most children should have a mixture of baby and adult teeth by this age, and the bite is established. This also is a good time for an evaluation if your child hasn’t lost any of his baby teeth yet. We can take a set of X-rays to evaluate the situation and determine whether interceptive action should be taken.

When to Extract Baby Teeth

It seems every rule has an exception, and there are occasions when one or more baby teeth should be extracted before they naturally fall out.

Following are some reasons your child’s dentist may recommend removal of a baby tooth:

  • It is decayed or infected beyond the point of being repaired
  • Dental trauma
  • There are problems with your child’s dental growth pattern or normal shedding schedule of the teeth

A tooth extraction may be recommended for orthodontic reasons, too. Sometimes tooth removal is beneficial to the surrounding teeth. For example, in a situation where a baby tooth is in the way of an adult tooth and preventing it from erupting properly, extraction may be recommended.

Sometimes an orthodontist may want a baby tooth removed to speed the start of orthodontic treatment.

These exceptions to the rules are another reason why an orthodontic evaluation at age 7 is a good idea. Potential problems can be identified and monitored if necessary. This keeps the orthodontist well informed so appropriate treatment can be recommended when the time is right.