Milk teeth are fundamental not only for chewing function of the child but also for the proper development of permanent dentition. The final teeth break into the gums following the roots of the corresponding milk teeth and take up the space at the right time.
For this reason, milk teeth should never be lost before the eruption period of the permanent tooth. Choosing whether or not to treat these issues depends, therefore, on the child’s physiological replacement for the definitive tooth. Up to the ages of 8-9, treatment is almost always indicated, while at a later date the dentist can make the most appropriate decision between treatment, extraction or waiting. In the case of early loss due to cavities it is often necessary to set up small gadgets (keepers) that ensure that the correct space for permanent teeth which have not yet erupted.
When the space of a small tooth which has fallen out too soon is occupied by nearby teeth and not by the corresponding definitive element, the whole mouth is subject to the risk of severe malocclusion.
In order to know how to orientate the operator the parent will be reminded of the age of changeover age for the milk teeth.
At 6 years old: the first permanent molar erupts, also called "6-year-old tooth". This tooth is eroded at the bottom of the gum, does not replace any milk tooth and for this reason the parents do not always realize its presence. It is a tooth of fundamental importance for the development of dentition and its health and should be considered a priority.
At 6-7 years old - first phase of transition: the incisive groups are in the process of growing, the top being 6 months ahead in comparison to the lower ones.
Cavities of milk incisors are very rare, and in the case they appear around the ages of 5-6, it does not make sense to provide a cure to the affected teeth.
At 9-11 years old - second transition phase: lateral milk teeth are growing, represented by molars and deciduous canines.
Early loss of the upper deciduous canine and the second upper and lower decidual molars is particularly dangerous for the risk of malocclusion and should always be brought to the attention of the orthodontist.
When parents are asked whether to treat milk teeth, the response should make the parent aware of the importance of the chronological moment in which cure is useful or useless, depending on the child's age and the subjective timing of tooth changes of child.
