The Doctor's Corner

Every fall in Ohio, the deciduous trees shed their leaves until the branches are bare. When that happens, we know that winter is on its way. Like trees that shed leaves, children shed all twenty of their deciduous teeth between the ages of 7 and 14 and when that happens, young “adulthood” is on its way. Unlike the trees that shed every leaf, children often have deciduous or “baby” teeth that do not shed. They become retained for unknown reasons and thus the permanent teeth that follow have to work around them and often erupt in a poor position. Sometimes these permanent teeth become blocked and impacted or in a position that will never allow eruption.

The shedding, or “exfoliation” of teeth begins at around 7 years of age. That is why orthodontists would like to see all children at age 7; to make sure the baby teeth are getting loose and the permanent teeth have room to erupt. A digital panoramic x-ray is usually taken at age 7 or 8 to see if all the permanent teeth are present and forming properly. The upper and lower front teeth erupt between 7 and 9 and often the orthodontist has to direct the dentist to remove baby teeth to allow proper eruption of the permanent teeth that follow. In some cases, the baby teeth fail to get loose and if they are not removed, the poor eruption can cause a front cross-bite which is damaging to the newly erupting lower permanent front teeth.

The baby canine teeth should be loose or exfoliated around the ages of 10 to 12. When these teeth fail to get loose or fall out, the permanent canine teeth often grow sideways in the bone and become impacted. If this happens, it requires an oral surgery procedure and an extra year of braces just to get this tooth back down into the proper position. Obviously, the expense is much greater as well as the difficulty of the treatment.

Although some late bloomers still have baby teeth at age 14, many early bloomers have lost all their baby teeth at nine! So waiting until 12 or 14 to be checked for proper tooth loss may be way too late! Also, you should never see two teeth in the same spot. If a permanent tooth is erupting and the baby tooth is still there, call your orthodontist or dentist and have the baby tooth removed.

It would be nice if children were like trees and exfoliated teeth like leaves but since they are not, make sure your child is evaluated for proper baby tooth loss at age seven and every 6 months after that.