by: Dr. Ian Gray
Everyone is born with two sets of teeth; their primary (baby) teeth and their permanent (adult) teeth. Typically a complete set of primary teeth have 20 and a complete adult set (with wisdom teeth) have 32. Both sets of teeth serve a purpose and if lost prematurely may cause problems with the rest of the mouth such as; bite/TMJ issues, shifting/hyper-eruption of other teeth, bone loss and ultimately loss of other teeth in the mouth.
The baby teeth typically start erupting by 6 months of age with the lower central incisor teeth. This eruption process though is not carved in stone and can vary for each child. It is imperative that the baby teeth are kept until the adult teeth are ready to come in. It is a fallacy that baby teeth serve no purpose and if a problem occurs just to remove them. Premature loss of the baby teeth can cause shifting of adjacent teeth thus when the adult tooth starts to erupt it may have no room to grow into and either may fail to erupt or come in an odd way. If a child develops a cavity, fracture or damage to a baby tooth due to injury it is imperative to try and keep the tooth until it naturally exfoliates. At times it may not be at all possible to keep a baby tooth due to extreme damage, in this circumstance a space maintainer may be recommended to keep the space open for the adult tooth to erupt into in the future.
The permanent/adult teeth typically start to erupt around the age of 6, but as with baby teeth this is not carved in stone and may vary. When the adult teeth start to move upwards towards the gums it starts to dissolve the root of the baby tooth and ultimately the tooth falls out. When an adult tooth first erupts in the mouth it is not fully mineralized/full strength and may take a few years for the enamel to become its strongest. It is in this time period that the tooth needs fluoride exposure, as fluoride is what helps mineralize/strengthen the enamel of the tooth. Without fluoride, exposure to cavity-causing bacteria and carbohydrates, the tooth may become prone to dental cavities/decay. As a dental professional the goal is to prevent any decay before it starts; teaching good oral homecare habits and application of fluoride both in the dental office and at home in toothpaste is imperative for prevention. Many communities also have fluoridated water which helps in prevention of decay. Unfortunately, not all of them are. Supplemental fluoride is recommended to prevent decay; this can be discussed with your oral healthcare provider.
Premature loss of a baby tooth or loss of an adult tooth should try to be avoided at all costs. A missing tooth may seem like no big deal but it can have a tremendous effect on your oral cavity. A missing tooth can put extra stress on the remaining teeth, think of it like a fence with a missing picket, ultimately the other pickets will have to do the work of the missing one, ultimately weakening will occur. When extra stress is put on the remaining teeth due to loss, they can weaken causing fracture, loss of bone surrounding the teeth and shifting/tipping/hyper eruption into the space. A missing tooth can also alter your bite (how your teeth meet together) and may also cause TMJ (jaw) joint problems. When a tooth is lost or extracted, discussion of replacement of the tooth is priority to prevent these problems. Remember to take care of all of your teeth, primary or permanent because you only get the two sets!