Loss of deciduous teeth – is timing important to the gdp?

Timing of deciduous tooth extractions has been widely discussed in the literature. Papers focusing on the indications for early extraction, the management of retained deciduous teeth, serial extraction and balancing extractions are commonplace. This article aims to give an overview of the impact of the timing of tooth loss on the developing occlusion and provide guidelines as to when interceptive treatment is indicated.

The aim of interceptive orthodontics is to influence therapeutically a developing/developed malocclusion in order to reduce further problems and attain a normal occlusion. The timing of deciduous tooth extractions is an important aspect as it influences the development of occlusion.1

Deciduous tooth extractions may be required as part of an interceptive approach; often the first stage of orthodontic care which aims to guide the developing occlusion closer to that of the ideal occlusion.

Eruption can be defined as ‘the biological process that follows the formation of the dental crown and is essentially penetration of the covering oral mucosa by any part of a single tooth’.2 The time of eruption of both the deciduous and permanent dentitions occur over a wide age range and are affected by endocrine, genetic and dysmorphic factors. Environmental factors such as ethnic origin, socio-economic group, climate and fluoride concentration can also have an effect.3