Kusp Pediatric Dentistry

Can I replace my child’s front baby teeth?

Baby teeth serve so many purposes, chewing, speech development, holding space for the permanent teeth, and of course for those delicious smiles. Most children will begin losing their baby teeth between the ages of 4.5 and 9 years. There are some circumstances in which the front baby teeth are lost prematurely or are removed by a dental professional. The most common reason younger children lose their primary incisors (front teeth) early is one, Early Childhood Caries (decay) or two, dental trauma that results in early loss of the primary tooth. In more rare circumstances, a child may be congenitally missing a baby tooth.

Early childhood caries, or decay in the baby teeth can be due to many factors. Anything from diet, hygiene, saliva quality and quantity, to night time nursing or bottle feeding on demand after the age of two. (See our link on decay here). When the decay becomes very extensive sometimes the only option to get a child out of pain or discomfort is to remove the teeth. We do everything in our power to avoid this but in some cases, we have no feasible means to restore a tooth that is severely compromised or a tooth that is infected and beyond healing. When multiple teeth are lost under these circumstances a young child may be left with a gummy smile, devoid of the front teeth. This can be extremely difficult for a parent to see and often parents will have a heavy feeling of guilt – even when it may have been out of their control. Mom is guilt is real, no?!

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Another part of being a parent is watching your toddler endure lots of little bumps and falls.  Those front baby teeth get lots of impact during this time. It’s quite amazing to have a set of teeth that can endure so many little injuries yet have an amazing ability to heal. As toddlers learn how to walk, run, jump and climb they become very injury prone especially between the ages of two and three.  Exploring their environment and honing their gross motor skills makes the front teeth in particular susceptible to bruises, bumps, and small chips. On more rare occasion, larger falls and impact to the front teeth can result in the loss of the baby tooth (or multiple teeth). This is always devastating for the child, parents, and dentist.

close up of child smiling - Kusp Pediatric Dentistry in Beverley Hills, CA

Regardless of the reason, the loss of the front baby teeth in a young child can always be challenging. Parents worry that a child will have a more difficult time chewing, speech development, while other parents are concerned their child will be teased for having missing teeth. These are all valid concerns. Many times parents will ask about a “pedi partial” also known as the Groper appliance (I know – the name is a little uncomfortable). This appliance (see figures below) is a cemented appliance that replaced the missing baby teeth with false or acrylic teeth. Parents hope that with this appliance their child will have a better ability to eat, function, speak, and restore the original smile. However, according to Waggoner and Kupietzky (Pediatric Dentistry – 23:2, 2001) while “masticatory function, speech development, and tongue habits may be of some consideration, there is no strong evidence that early loss of maxillary incisors will have any significant, long-lasting effect on the growth and development of the child”. And thus, this appliance only serves one real function, which is to restore the esthetics. This does not come without a price. Cementing an appliance in a child’s mouth has some implications. These appliances, while restoring the esthetics, also tend to accumulate excess plaque and food debris and may increase the risk for the child to have cavities again in the remaining teeth. Also, this appliance is not fool proof, if children constantly put toys or fingers in their mouth or fall and bump the appliance – the false teeth may pop out and the repair process is often difficult on the child. Overall, this appliance is a completely elective appliance with no true functional necessity. Below is Dr. Adi’s patient who had worn this appliance until his permanent teeth were ready to erupt. 

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