Few things bug us more at TDR than double parking. No, not the double-parking that you are thinking of (although that is very annoying as well). The double-parking that I am talking about is when you have a baby tooth and its adult twin occupying the same space. Not only does this make you look like a character out of a sci-fi movie but it also can have long-term consequences. So why do we want you to get baby teeth out as quickly as you can after they get loose? Read on and you can find out!
First, let’s talk briefly about what ages you can expect the baby teeth to exfoliate (our fancy scientific term for the loss of a baby tooth). The first wave of baby teeth is generally lost around 7-8 years of age. These are the 8 upper and lower incisors. After this first wave there is a quiet period where no teeth will be lost. The second wave begins normally around 10 years old and can last 1-2 years. In the second wave the final 12 baby teeth are lost. The last baby teeth to be lost, in general, are the upper canines or lower second primary molars.
There are two main things that we worry about when baby teeth are not lost in time. The first is the redirection of the adult tooth that is supposed to replace it. If an adult tooth does not “hit the runway” perfectly it can head in the wrong direction and begin to erupt ectopically (another of those fancy terms which means that it is erupting in the wrong spot). Ectopic eruption often causes treatment to be prolonged because we need to work harder in order to get the tooth to the correct position. The worst type of ectopic eruption is when a tooth becomes impacted (has gone off track so far that it will not erupt into the mouth without intervention). The upper canines are the most common teeth to become impacted (see the x-ray for an example of an impacted canine). Often if we suspect that this will be an issue we will ask for the baby canines to be removed to help give the permanent canine a better “runway” to land on. If they do not hit the runway we have to go in after them, but that is another subject altogether.
The second issue with retained baby teeth is that food can get trapped underneath the loose baby tooth and cause problems with the adult tooth that it is covering. It is not unheard of to have a cavity on an adult tooth that has recently erupted because of this. While this does not have any effect on our orthodontic treatment, we never want to have our patients risk cavities due to baby teeth that don’t want to come out.
Why are baby teeth so darn stubborn sometimes? There are a couple of reasons. First, the back baby teeth have several roots on them and if an adult tooth does not dissolve all of the roots that baby tooth will hang on for dear life. Often these require the help of your dentist to kick them out of the party. Second, gum tissue can be very strong. The majority of retained baby teeth are simply being held in the mouth by the tough gum tissue surrounding it. All it takes to remove these is some persistence and willingness to wiggle that thing out of there!
So when you are in the office and we ask you to wiggle out those baby teeth, please do it! We never ask our patients to do things without a reason.