A young child has early molar loss and posterior bone loss. What next?
Establish whether the tooth loss and bone change are pathological rather than related to normal exfoliation or eruption.
- Assess attachment, mobility, indicated imaging, medical and family history, and systemic or genetic clues.
- Coordinate pediatric and periodontal evaluation for destructive disease.
- Preserve teeth when feasible, but reassess prognosis if persistent infection threatens the child or developing successors; extraction is an individualized multidisciplinary decision.