Baby teeth, also called primary or milk teeth, serve an important function in the development of permanent tooth placement. If baby teeth are pulled too soon or stay in place for too long, it can adversely affect the eruption pattern and alignment of the permanent teeth. It is important to speak to an orthodontist before making any decisions about baby tooth extractions.

When to Pull Baby Teeth

Primary Tooth Loss Schedule

Baby teeth are typically lost at certain ages. These ages may vary slightly from child to child, but should follow a certain pattern that corresponds to the pattern of permanent tooth eruption. If a child begins to lose teeth in a pattern that is outside of the normal eruption schedule, it may cause crowding in the mouth or misalignments. If a child goes several years over the normal tooth loss schedule, it may delay permanent tooth eruption or cause existing permanent teeth to shift into unnatural placements.

Baby teeth are generally lost around the following ages:

  • Between ages six and eight the lower and upper central primary incisors are lost
  • After central primary incisors, the lower and upper lateral incisors are lost
  • Between ages eight and ten there is a one to two year pause
  • Between ages ten and thirteen the lower canines and first molars are lost
  • Following the first molar loss, the upper canines are lost, then upper and lower molars

Extraction Considerations

If a baby tooth is damaged or begins to decay, it may be necessary to extract the tooth in order to save gum health and eliminate pain. However, extracting a baby tooth before it is time for the permanent tooth to erupt can allow surrounding teeth to shift to fill the gap. If the tooth can be saved, orthodontists often recommend using other methods so that the gap is naturally filled until the permanent tooth comes in. If it becomes necessary to extract a primary tooth, the orthodontist may recommend filling the space with a prosthetic tooth until the permanent tooth comes in. It may also be necessary to fill a space with a prosthetic tooth if more than three months pass between the loss of a baby tooth and the eruption of a permanent tooth.

Primary Tooth Extraction Benefits

If primary teeth are pulled at an appropriate time, it can sometimes prevent later complications. Pulling primary teeth will not permanently solve crowding issues, but it can help orthodontists guide permanent tooth development patterns so that straightening procedures and surgeries that would have been necessary later can be avoided. However, every child develops differently. Parents and orthodontists should discuss all possible remedies for childhood tooth complications before making the decision to extract baby teeth.Many jaw and tooth problems can be corrected with braces or other orthodontic tools and procedures. However, more severe complications may require orthodontic surgery to correct. Also called orthognathic surgery or corrective jaw surgery, orthodontic surgery can be useful in correcting conditions that are caused by congenital deformities, injuries, and developmental issues.

Orthodontic Surgery Lee Vista, FL

Orthodontic Surgery Indications

Jaw, ear, and head pain can all be indicators of abnormalities in the jaw structure that may require surgery to correct. If regular jaw functions such as eating, breathing, or speaking cause pain or are difficult, these factors may also indicate the need for orthodontic surgery. These issues should be discussed with an orthodontist in order to determine the need for surgery and pinpoint the exact cause. Orthodontists may not perform the diagnostic tests necessary to catch certain conditions if not alerted to these pain sensations.

Visible Indications

In some cases, there may be visible indications that surgery is necessary. A receding chin or dominant overbite may indicate skeletal malformations that require surgery to correct. Correcting these conditions can help to boost confidence and can have emotional benefits as well as medical and cosmetic benefits.

Diagnosing Conditions Requiring Surgery

Assessing the need for orthodontic surgery is not always simple or straight forward. Collaboration between an orthodontist, dentist, and an oral surgeon is often the best approach, as braces may be required to successfully complete the correction, and other factors such as tooth health may come into play. Diagnostic tests such as x-rays may be used to determine the extent of the problem and identify the most effective surgical and procedural options.

Orthodontic Surgery Considerations

Depending on the condition that will be corrected using surgery, patients and orthodontists may have to take certain factors into consideration prior to surgery. These factors include subsequent or preliminary surgeries and procedures that may be necessary and patient appearance following surgery. There is software available that can allow patients to view projected results of orthodontic surgery, and this may help to determine whether braces or cosmetic surgery will be needed following surgery. Patients may also need to consider overall cost factors and plan accordingly for all eventualities. If orthodontic surgery is undergone and follow-up procedures are avoided, the desired results may not be achieved.

Conditions Corrected Using Orthodontic Surgery

There are many different conditions that can be corrected using orthodontic surgery, including but not limited to:
  • Tooth impaction
  • Tooth decay and abscess
  • Jaw misalignment
  • Cleft palate
  • Sleep apnea
  • Certain types of oral cancer
  • TMJ disorders