Extraction of first permanent molars in children Flashcards
What are the guidelines?
RCS 2023
For the first permanent molar, when is
a) eruption expected
b) root formation completed
c) coronal completion
a) 6 years
b) 9 years
c) 3 years
Why is the first permanent molar a particular problem/more susceptible?
First permanent tooth to erupt - poor oral hygiene, inaccessibility to back of oral cavity
Molar-incisor hypomineralisation - PEB
What must be considered in the decision to extract first permanent molars?
If the child is in pain
Medical, psychological, intellectual or patient management reasons why complex treatment isn’t accepted/ if GA required
The childs developmental age
Skeletal pattern, crowding, ectopic teeth
At what age does the extraction of the first permanent molar cause the least disruption to occlusion?
When the second permanent molar is developing - ages 8-10
What is the risk if the first permanent molar is extracted before 8 years?
7 can drift into extraction space, tip, rotate and produce spacing in dental arch with poor occlusal contact
When should a compensating extraction be done?
If the lower 6 has been extracted, the opposing upper 6 can be extracted if there is a clear occlusal requirement to prevent overeruption or if it is likely to be unopposed for a significant amount of time - but not routinely
When should you balance first permanent molars?
Not recommended to preserve centreline
Which arch has a better chance of achieving good occlusal position following extraction of first permanent molars?
Maxilla
At what age can the calcification of the 8s usually be seen and why is this helpful?
8 years
So the pt will have 2 molars in each quadrant so extraction of the 6s is more acceptable
When should the interceptive extraction of the compromised first molar not be done?
If 7s have erupted
No access to DPT
Acute symptoms of pain swelling or infection and it can’t be temporised
