There are multiple reasons why a child might be missing a permanent tooth, but it’s important to know that this does NOT disqualify them from getting braces. Even those with an incomplete smile can benefit from orthodontics—there just might be some extra steps. How does this work? There are three standard options for parents to consider, and the best one really depends on their child’s situation.
1. Replace the Tooth
A single missing tooth can be replaced either with a dental implant or a bridge, and each one comes with its own unique advantages. But when should this be done—before or after braces?
It’s usually easier to replace a tooth after braces, plus this allows the orthodontist to make enough room in the mouth for the restoration. Replacing a tooth before braces can complicate pre-existing bite or crowding problems, so it’s normally better to wait.
2. Close the Space Orthodontically
If a child has a missing permanent tooth, but there is still a lot of crowding because there is relatively little room in their mouth, another approach involves actually removing a second permanent tooth. This will provide the space necessary for the teeth to shift in response to braces. Choosing which tooth will be removed depends on the location of the missing one, and this new gap (along with the old one) will be gradually closed over the course of a braces treatment. By the time the process finishes, the child will have a perfectly symmetrical smile.
3. Preserve the Baby Tooth
Some children have congenitally missing permanent teeth, in that one or more of their adult teeth never developed. This can often cause a baby tooth to stick around for a long time because the process of it falling out isn’t being triggered by the incoming adult tooth. When your orthodontist examines your child, they may recommend simply preserving the baby tooth if it is in good condition and proceeding with braces. If it isn’t, then it will be removed, and a parent will have to choose from the other two options listed above.
What’s important to know is that this is not a rare situation for orthodontists—they help children all the time with missing permanent teeth. All you need to do is bring your child in for an exam, and their orthodontist will let you know what their options are and recommend which one might be best. While a missing tooth might make the orthodontic process a little more complicated, it can still give a child a healthy, attractive smile.
About the Author
Dr. Jeffrey Shirck is a board-certified orthodontist who has been helping children in the Columbus area for over 10 years. In that time, he’s worked with countless children with permanent missing teeth, so it won’t be a big deal if you bring them here! To learn more about their options and schedule a FREE in-person consultation at Shirck Orthodontics, click here.