If there are congenitally missing teeth, or larger than normal spaces in a child’s arches, what is the right thing to do?

Larger-than-normal spaces occurring in a child’s mouth are quite normal in the primary dentition. In fact, if spaces are non-existent, then that is already a certain indication that the child will develop crowding in the permanent dentition.

Spaces in the adult dentition can mean two things:

  1. The teeth are smaller than average in width to fit within the available arch space. Small, or “peg” teeth usually occur in the lateral incisors. (pictures showing incisor bondings)

  2. There is a tongue/space discrepancy where the functionally desired space for the tongue to fit within the palate and the arches is larger, therefore they get pushed out into a larger arch. (See the show case Missing Lateral Incisor.)