Around age 6, children will start shedding their primary teeth in the front and a new permanent molar will erupt just behind their baby second molar. This is the ideal timing to evaluate and diagnose their bite and its development. When a permanent tooth forms out of place (ectopic) it may not help the deciduous tooth to exfoliate so it remains (over-retained) until extracted.
Early orthodontic intervention is necessary to eliminate imminent dental crowding during this stage. It may required the extraction of some primary teeth to create room for the erupting permanent teeth. In some cases, the extraction of a permanent tooth may be essential to obtain proper spacing and alignment. This is know as Serial Extraction Therapy.