Baby Tooth Loss: Root Resorption & When Extraction Is Needed

Primary (baby) tooth exfoliation is a physiologic process driven by permanent tooth eruption.

Normal Physiology

• Root resorption: Osteoclasts dissolve primary roots as permanent successor erupts.
• Starts months before loosening; tooth becomes mobile, then exfoliates spontaneously.
• Sequence: mandibular centrals (~6 yr) → maxillary centrals → laterals → first molars → canines → second molars (~12 yr).

When Extraction Is Indicated

• Over-retained primary tooth blocking permanent eruption.
• Severe caries/pulpal necrosis with infection risk.
• Trauma with non-vital tooth.
• Orthodontic guidance (serial extraction).

Importance of Space Maintenance

Premature loss → adjacent teeth drift → space loss → malocclusion. Space maintainers (band-and-loop, Nance, lingual arch) preserve arch length.

Parental Guidance

• Don’t force loose teeth; let nature proceed.
• Maintain oral hygiene around mobile teeth.
• Dental visits every 6 months for eruption monitoring.