Diagnosis & Considerations
Premature loss of deciduous teeth
Clinical Considerations
Existing dental and skeletal relationships – is there a malocclusion?
An existing malocclusion has implications on the importance of maintaining leeway space and the use of space maintainers if early loss of primary teeth occurs (Scott and Atack 2015). For example, a dental Class II malocclusion can often be treated by extracting upper premolar teeth to allow for retracting of the upper incisors. However if an already Class II malocclusion in the mixed dentition patient has early loss of upper Es, the upper first permanent molars can drift mesially to more than a full unit Class II with severe crowding on the maxilla. This may warrant more than the usual 2 x premolar extractions or additional orthodontic anchorage to comprehensively correct the malocclusion later in the child’s life. A specialist orthodontist consult is warranted in these situations.
Is there spacing or crowding in the current dentition?
Early loss of deciduous teeth with existing crowding will cause more space loss, unlike an already spaced dentition which can afford some space loss without the development of crowding or a malocclusion (Crawford et al. 2008, Cobourne and DiBiase 2010).
