October 2, 2017

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.

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.