Primary Teeth: Importance and Care

    The Primary Teeth
    The primary teeth (a much better phrase than "baby teeth") are far more important to your child's future dental health than you may imagine.

    In addition to providing a proper chewing surface until age 12 or 13, normal healthy primary teeth form pillars that allow young mouths to develop correctly. Without the primary teeth, the permanent teeth which replace them could not assume their proper position in the mouth. The primary teeth help guide the permanent teeth into their final position.

    The primary molars are especially important. If a primary molar is lost prematurely and steps are not taken to preserve proper spacing, problems can quickly multiply.

    Let's take a look at normal eruption patterns; then find out what happens when your child loses a tooth prematurely.

    Normal Eruption Patterns
    The same basic eruption pattern occurs in each of the four quadrants of the mouth. To simplify this explanation, let's look at the upper left side of a normal developing mouth.

    Age 4

    The primary molars (A & B) have been in their proper position for two years or more, and the permanent bicuspids (1 & 2) are beginning to form. These teeth will eventually replace the primary molars. The permanent 6-year molar (6) is also in the formative stage.

    Normal development at age 4

    Normal development at age 6.

    		 Age 6

    The eruption process so far is normal. The primary molars (A & B) are still helping the child chew and are maintaining space for the permanent bicuspids (1 & 2). These bicuspids are exerting pressure, and the roots of the primary molars are beginning to dissolve (resorb). The permanent 6-year molar (6) has erupted into proper position.

    Age 10

    The root structure of the primary first molar has disintegrated and the tooth has been shed, creating an eruption path for the first bicuspid (1). The roots of the primary second molar (B) are resorbing normally. Within the next couple of years, it too will shed.

    Normal development at age 10.

    Normal development at age 12-13.

    		 Age 12-13

    By age 12 or 13, the primary molars have served their purpose and are shed. The permanent bicuspids (1 & 2) have replaced the primary molars. Notice that this space was maintained by the primary molars. The 6-year molar (6) remains in proper position. This position was stabilized by the presence of the primary molars.

    What a Tooth Is Lost Prematurely...

    Let's assume that unfortunately your child's primary first molar (A) is lost prematurely at age 6. Without the stabilizing influence of this tooth, the primary second molar (B) and the permanent 6-year molar (6) begin to move forward. When the space left by the primary first molar is closed, it prevents both permanent bicuspids (1 & 2) from erupting into proper position.

    Primary second molar moves into space.

    Permanent 6 year molar moves into space.

    		 In another situation, let's assume that the primary second molar is prematurely lost. With nothing to hold it in position, the permanent 6-year molar (6) migrates forward and closes up the space. Once again, there will not be enough room for both permanent bicuspids (1 & 2) to erupt properly.

    Stopping Problems Before They Develop

    The Space Maintainer

    This time let's assume that your child's primary molar is prematurely lost, but a dentist steps in to prevent unnecessary problems.

    Treatment for loss of the primary molar is simple, but critical. It requires construction of a space maintainer, an appliance that preserves the space left by the prematurely lost tooth. Later, when it is time for the permanent bicuspids (1 & 2) to erupt, they will have adequate room.

    To your right is a typical lower space maintainer. Of course there are many variations.

    The Stainless Steel Crown

    Dentists prefer to restore a primary tooth using conventional methods and materials. However, in cases where decay or bite problems have caused severe deterioration, other measures must be used to adequately restore the tooth.

    In such situations, a stainless steel crown is preferred. When cemented in place, the stainless steel crown forms a protective covering for the tooth.

    Why X-Rays?

    A periodic x-ray examination is an important part of the dental examination. X-rays give your dentist an opportunity to see beneath the surface to detect small problems before they become major ones. Dental problems, when detected early enough, can be treated with little or no discomfort to the young patient.

    A space maintainer at work.

    A lower space maintainer in place.