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Premature Loss of Primary Teeth

Premature Loss of Primary Teeth

The early exfoliation of primary teeth is invariably associated with serious systemic conditions and requires investigation. Most of these conditions are rare, however, clinicians need to be aware of the uncommon presentation of tooth loss. Early loss of primary teeth can be divided into:

• periodontal disease (Table 40.1);
• metabolic diseases;
• connective tissue disorders;
• neoplasia;
• self-inflicted trauma.

Table 40.1 Periodontal diseases in children.

A summary of the proceedings from the meeting that ratified the new nomenclature can be found in Research, Science and Therapy Committee, American Academy of Periodontology (2003).

Periodontal Disease in Children

Gingivitis is common in children but periodontal disease with loss of alveolar bone is rare prior to adolescence and almost always results from a primary immunological disturbance. These may be:

• neutropenias (<1500 cells/ml):
  • congenital neutropenia (Fig. 40.1);
  • cyclic neutropenia;
  • agranulocytosis;
  • neutropenia secondary to chemotherapy;
• qualitative neutrophil disorders (chemotactic or phagocytic defects):
  • leucocyte adhesion defect;
  • Papillon–Lefèvre syndrome;
  • Chédiak–Higashi disease;
  • acatalasia.

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