Diagnosis & Considerations
Poor prognosis permanent teeth
Clinical Considerations
Is the tooth/teeth important during occlusal development?
The eruption and maintenance of teeth in the occlusion can be important for the occlusal development of a child. Early loss of these teeth can lead to arch length discrepancies, midline deviations and malocclusion development (Royal College of Surgeons 2006, Cobourne and DiBiase 2010).
Is the tooth/teeth important during stages of orthodontic treatment?
Certain teeth are important during the orthodontic treatment of different types of malocclusion. For example, poor prognosis upper premolars or molars should be maintained until orthodontic treatment before their extraction so their space can be used for orthodontic retraction of incisors (Cobourne et al. 2014). The teeth can also act to support the arch length for patients and avoid a deep bite or unnecessary spaces developing. A specialist orthodontist consult is important.
At what ages can the tooth be extracted with increased chance of complete space closure?
First permanent molars extractions (Cobourne et al. 2014):
- When the second permanent molars have less than 1/3 root formation
- On confirmation of the third molar development is present
- When there is minimal crowding
- If possible, when early or comprehensive orthodontic treatment can be performed
