The Importance of Early Orthodontics: Why It Is Important to Remove Baby Teeth at the Right Time @ Daechi-dong Orthodontic Dental Clinic Yonsei Jeongwon Dental Clinic

Early Orthodontics, Yonsei Jeongwon Dental Clinic

Hello. I am Yoon Jung-won, chief director of Yonsei Jeongwon Dental Clinic, an orthodontic dental clinic in Daechi-dong.

These days, when children lose a baby tooth for the first time, they go to sleep with the lost tooth by their bedside, saying that the tooth fairy takes the tooth and leaves a coin, right? When I was little... well, not when I was a child, but when I was younger, I read in a children’s book that if you throw a lost tooth onto the roof, a magpie will take it away. Haha.

I still remember when my son lost his first baby tooth, he said, “Take my tooth and give me money...” and wrote what he wanted to say to the tooth fairy on a small card before going to sleep. Haha. Every time he lost a baby tooth, I felt like I couldn’t ignore the notes he left, so once I printed out an official tooth fairy report I found on Google and left it with the tooth. But my son found the image file on the computer and eventually caught me! Haha.

Source: images.app.goo.gl/keGpwG3Bjjv6FJxu7

The story drifted off somewhere else!

Sometimes, when people come in for orthodontic treatment because of crooked teeth, there are quite a few cases where teeth did not erupt in the right place because a baby tooth fell out too early, leaving no space for the surrounding teeth to come in, or because a baby tooth was not loose but should have been extracted a little earlier for various reasons and the extraction was not done in time.

Loss of eruption space

If a baby tooth falls out early because of decay or dental trauma, and the space is simply left empty, the surrounding teeth may tip into that space, leaving insufficient room for the permanent tooth to erupt later. When space becomes insufficient like this, tooth alignment naturally becomes disturbed, and the need for orthodontic treatment may increase.

Band & Loop (images.app.goo.gl/14YpXBACML6RG8hH7)

To prevent this, when a baby tooth falls out early, a space maintainer should be used to preserve that space so that the permanent tooth can later erupt into the correct position.

The most commonly used space maintainer in this case is the "Band & Loop appliance." A band, like a ring, is fitted around a molar, and then a thick wire is attached to prevent the teeth around the missing tooth from tipping into the empty space. This appliance is removed after the crown of the permanent tooth has emerged above the gums and more than two-thirds of the root has formed.

In addition, there are other space maintainers such as the distal shoe space maintainer, used when the baby molar in front of the first permanent molar falls out before the first permanent molar erupts and a ring-shaped band cannot be placed on the permanent molar; the Nance holding arch, which is used when multiple baby teeth have fallen out and bands are placed on both upper molars with a resin acrylic stop on the palate to prevent the molars from moving forward; and the lingual arch, which is used on the lower jaw.

Distal Shoe	Nance Holding Arch	Lingual Arch

Also, about my son.

His teeth were already slow to erupt, but since his baby teeth were taking so long to fall out, I took a panoramic X-ray of my son as part of a regular checkup, and the relationship between the upper right canine and premolar looked unusual! The two teeth marked with purple lines in the photo above are the canine and the first premolar that should have erupted. However, I was not pleased with the eruption angle of the first premolar. Compared with the opposite side, it was clear that the premolar was erupting tilted backward, and the adjacent canine could not come down.

There was still some root left in the baby molar, so it was not yet time for the baby tooth in the light green circle to fall out. After some thought, we decided to extract the baby tooth first.

We decided to remove the baby tooth first to create space so that the premolar could come down more quickly.

Because we did not want the space created by the extraction to narrow even a little, we decided to use a device to maintain the space needed for the premolar to come down. Since it was not a suitable location for an appliance like the Band & Loop mentioned earlier, after some consideration we made a removable appliance that could be taken in and out, and told him to wear it only while sleeping at night.

This is a panoramic X-ray taken about six months later, and you can see that the eruption angle of the premolar, which had been tilted far backward, improved significantly. After that, he wore the appliance consistently for almost a year, and only stopped wearing it once the premolar had popped out above the gums :)

This is a panoramic X-ray taken recently. The canine in that area has not fully erupted yet, but you can see that the eruption angle has improved.

If the space created by a baby tooth falling out early cannot be preserved with a space maintainer such as the Band & Loop, distal shoe, Nance holding arch, or lingual arch mentioned above, the permanent tooth may remain impacted due to lack of space, or may erupt crookedly into a position different from its original eruption path. The canine crowding commonly referred to as Dracula teeth also often occurs when the baby canine falls out too early and there is insufficient space for the permanent canine to erupt. In such cases, orthodontic treatment is needed to create space for the canine to come down.

In the case of the patient above, there was not enough space for the left canine to come down, and the right front teeth had also moved inward and were biting in reverse. The right second premolar was also caught between the teeth in front of and behind it, so it could not come down. Of course, orthodontic treatment could also be done later as an adult (and the likelihood of extraction orthodontics would be higher), but to help avoid complicated orthodontic treatment later, we decided to create space in advance before the other teeth erupted.

During hands-on training at dental school for making removable orthodontic appliances, there was one appliance that earned the highest score and was also the most difficult to make... the "sagittal appliance," which is used to correct cases like this. The role of this appliance is to push the front teeth forward and move the molars backward in order to secure space for the canines to erupt.

In the case of the patient above, we added a push spring to move the inwardly positioned front teeth forward, and a distal screw to create space for the premolars that could not erupt because of lack of space, on the sagittal appliance. I think this must be a 10-point, highest-difficulty appliance ^^;;

Sagittal appliance with distal screw and push spring

The photo below is a similar case to the patient above, and was excerpted from a textbook on orthodontics. A sagittal appliance was worn to create space for canines that could not erupt because of lack of space on both sides, and as a result the canines erupted dramatically and the front teeth that were biting in reverse were also corrected. If this kind of removable appliance treatment had not been done when the child was young, this would have been a case that later required extraction orthodontics.

As such, in cases where a baby tooth does not fall out on time and there is not enough space for the permanent tooth to erupt, requiring space to be created, or in cases where a baby tooth needs to be extracted in advance so that a permanent tooth can erupt properly, I believe pediatric orthodontics is essential because it can make the process a little simpler before children grow up and undergo full orthodontic treatment. To provide this treatment on time before it is too late, regular dental checkups are truly important.

In the next post, I will talk about growth orthodontics for underbite and prognathism!

Orthodontic treatment at Yonsei Jeongwon Dental Clinic includes the diagnostic fee and monthly fees (excluding the cost of retainers), so you do not need to worry about additional costs. In addition, since we also have a general dentistry department, all treatment needed for orthodontics, such as extractions and cavity treatment, can be done in one place. We also offer an installment payment system to reduce the burden of paying a large sum at once, which makes it even more appealing.

Yoon Jung-won, the chief director in charge of the orthodontics department, has specialized in orthodontics for 16 years of clinical experience and has treated many high-difficulty cases. Therefore, various orthodontic cases such as malocclusion, protruding mouth, and underbite can be treated effectively.

Pediatric orthodontics at Yonsei Jeongwon Dental Clinic

If you visit Yonsei Jeongwon Dental Clinic, an orthodontic specialist clinic in Daechi-dong, you can accurately understand your current condition through a simple oral examination at no additional cost, and during orthodontic consultations you can also hear explanations about various orthodontic appliances, so please feel free to contact us for a consultation.

Yonsei Jeongwon Dental Clinic is equipped with all the latest necessary devices for orthodontic treatment, including the iTero Lumina 3D oral scanner, growth plate examination, and before-and-after treatment simulations using the Morpheus facial scanner, allowing for more precise and systematic orthodontic treatment.

Perhaps those of you considering orthodontic treatment because of protruding mouth, crowded teeth, malocclusion, underbite, and so on have already gathered a lot of information through searches. Even so, comparing the different appliances in person and hearing detailed explanations will be very helpful in making your decision.

During consultations, you can compare various appliances such as Clarity, Clippy-C, and Invisalign with your own eyes and hear detailed explanations of their pros and cons, so we recommend calling or visiting for a consultation without hesitation.

Yonsei Jeongwon Dental Clinic is not only convenient for parking, but also very easy to visit from Samseong Station, Hakyeoul Station, Daechi Station, Hanti Station, as well as Samseong-dong, Daechi-dong, Gaepo-dong, Irwon-dong, Dogok-dong, Yeoksam-dong, and Jamsil.

Building next to BMW at the Woosung Apartment intersection in Daechi-dong

(Across from Starbucks / Samsung Store)

Yonsei Jeongwon Dental Clinic, the orthodontic clinic in Daechi-dong, offers convenient and free parking

Consultation and inquiries: 02-501-2879