Q.         My 6 years old daughter has some crowding of teeth and 3 of her lower permanent incisors have erupted and the fourth one is impacted as per the dentist. He advised me to get the lower baby canines removed. I want to know how beneficial this approach is and any long term problems with it. Will the permanent canines erupt on time and how she will be biting for next 5-6 yrs.

A.         This is not uncommon. If both lower canines are removed then that will give enough room for the impacted incisor to come in. Your daughter will then have probably have some extra room and may need a space maintainer to hold the extra space after the fourth incisor erupts. Another option is just removing the canine on the side of the impacted tooth. Her midline will be off but that will be corrected in the future with braces. She is definitely heading that way. The permanent canines will need to be monitored on their eruption because the chance that they may be blocked out later is possible. She will have no problems biting. All my patients with this issue are fine with biting.

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