Early extraction of first permanent molars: applying the evidence

Abstract

First permanent molars (FPM) are often of poor prognosis due to caries or molar incisor hypomineralization. If extraction can be planned then FPM may be extracted at a suitable time to allow spontaneous space closure from the second molar, or retained for the space to be used for orthodontics in the future. There are several evidence based patient and dental factors to consider in planning these cases. This paper illustrates these factors through a case series. CPD/Clinical Relevance: Ideally, poor prognosis 6s would be managed by a paediatric dentist and an orthodontist. However, where these services are not available, the general dentist should be aware of factors influencing treatment.