Although baby teeth stay in the mouth for only a few years, they have an important job in helping the permanent teeth come in at the right position: holding space. Baby teeth lost early to decay can set the stage for orthodontic problems such as crowding later on.
How does space loss happen?
When a baby tooth, especially a baby molar, is extracted before its time, the neighbouring teeth gradually drift into the gap. This drift narrows the space reserved for the permanent tooth coming in underneath. When the permanent tooth tries to erupt, it may:
- Come through in the wrong direction,
- Remain impacted,
- Push the other teeth and cause crowding.
When is the risk higher?
- Early loss of baby molars
- Loss of more than one baby tooth
- In jaws that are already narrow
- When the permanent tooth is still a long way from erupting
What is a space maintainer?
A space maintainer is an orthodontic appliance that keeps the gap left by a baby tooth lost early open until the permanent tooth comes through. It can be fixed or removable. Whether one is needed is decided by assessing the lost tooth, the child's age and the eruption stage of the permanent tooth on an X-ray. For details, see our orthodontic appliances page.
Why is treating decay important?
Preserving decayed baby teeth with fillings or, where needed, a baby tooth root canal treatment lets the tooth fall out at its natural time and prevents space loss. That is why decay in baby teeth should not be put off with the thought "they will be replaced anyway".
Advice for parents
- To prevent decay, brush your child's teeth twice a day with fluoride toothpaste.
- Visit the dentist for a check-up every six months.
- If a baby tooth has been extracted, always ask whether a space maintainer is needed.
- Plan the first orthodontic check-up at around age 7.
For the signs of crowding and when an assessment is needed, see our article on crowding in children.
