Space Maintainers

It’s just a baby tooth with a cavity, so the dentist removed it.¬†Unfortunately, that’s not the end of this story.

If the removed baby tooth was a back tooth, it can allow the adult teeth behind it to tip forward and block (impact) the tooth under the removed baby tooth. This can lead to an expensive braces treatment to correct the problem.

If the removed tooth is a corner tooth (cuspid) it will cause the front adult teeth to lean to that side making the center of the teeth not match the center of the face.

When a baby tooth is removed by the dentist after age 5 that is the time for an evaluation by the orthodontist. Often the front teeth can be centered by removing the baby tooth cuspid on the opposite side, then there is equal space on both sides and the front teeth upright all by themselves.

At the time the back baby tooth if removed, a spacer (space maintainer) can be placed to hold the place for the adult tooth until it comes to the surface. Once the spacer is placed, it needs to be checked at regular intervals so it can be removed at the proper time. If left in place too long, it can interfere with the adult tooth growing.

Why does my child need braces when there are still baby teeth?

When your child has a mix of adult and baby teeth is a complex time in the growth of teeth and the development of your child’s face. The process of an adult tooth growing, heading in the right direction, pushing out the baby tooth, and getting to the ideal position in the mouth is complicated. Often times a growing tooth will not read the instruction manual and get into trouble. Dentists still do not understand the details of the tooth eruption process completely.

Many things in this process can go wrong, or be problematic. For instance, a tooth can start growing in the wrong direction so it shows up to the side of the baby tooth instead of pushing the baby tooth out of the way. This is called an ectopic tooth. If the dentist does not remove the baby tooth promptly, the adult tooth will be pushed even further out of line.

If your child has crowded front teeth, there is a much greater chance of the eye teeth becoming stuck inside the jaw (impacted) and not able to come to the surface.

If the two adult front teeth are widely spaced, there may not be enough room for the second teeth, and they can be re-directed into the palate behind the front teeth.

The upper jaw may be too narrow which can cause multiple impacted teeth.

The orthodontist is trained to identify all these things and more. The correction is usually uncomplicated. Your dentist will appreciate the advise and recommendations of the orthodontist in these growth and development issues.