Just about every dentist has heard a parent say "They're only the baby teeth'' at some time or another. Generally this is said at a dental visit when decay has been found in the primary teeth (baby teeth). This belief is responsible for a variety of dental problems, some of which can last long after the primary teeth have been lost.

The primary teeth are important in the development of proper speech, nutrition and facial form. They maintain the space for the permanent teeth and guide the permanent teeth in their eruption. Loss of the primary teeth can cause short-term and long-term problems.

When a child is learning to speak the teeth help guide the tongue into position. The absence of teeth in this process may result in a lack of clarity of speech in some children. While this problem is usually temporary, the effect upon self image and confidence in speaking may be long-lasting and detrimental.

Another aspect of the problem which can significantly affect self image is appearance. If the people who surround a child are insensitive (especially the other children), the child may begin to feel self-conscious. This may be manifested by an unwillingness to smile or talk, especially to new people.

Even in the most supportive of environments there may be a sense of looking different from the other children. This requires sensitivity and encouragement from the adults responsible for the child.

One of the most basic needs for proper development is good nutrition. If development suffers, because of inadequate vitamin and caloric intake, the lost potential may never be regained. The primary molars are essential for proper chewing of fibrous foods. Vegetables and fruits which are high in fibre content may be difficult to chew if there are several missing primary teeth.

The essential vitamins contained in these foods may be missed if they are left out of the diet or if the food is overcooked to make it soft enough to be eaten without teeth.

The most obvious problem that results from premature loss of primary teeth is lack of space for the permanent teeth. This does not mean that every person you see with crowding had missing primary teeth. Crowding is often hereditary.

However, there are many instances were crowding and orthodontic treatment could have been avoided if the primary dentition had been maintained in a healthy state. This is most critical in the case of primary molars.

When a primary molar is lost prematurely the tooth behind will usually begin to drift forward into the empty space. This drifting permanently shortens the length of the dental arch and can only be regained by orthodontic intervention. Sometimes space loss can be minimised by the use of a space maintaining device. However, the device does not replace the chewing function of the teeth.

Prevention of these problems must start at birth. The use of a bottle for sleep and frequent sipping from a bottle during the day are the most common causes of early primary tooth loss. Even the natural sugars in milk and juice can create an environment where bacteria can flourish and decay can develop at a rapid rate. Later, frequent snacking and drinking between meals can cause the same problem.

Developing proper nutrition and oral hygiene habits from the start will help prevent premature loss of the primary teeth. Clean your baby's teeth and gums after feeding and before bed. Regular dental check-ups should start between 18 months and two years of age, or sooner if there are problems. Your dentist can provide you with oral hygiene instruction and other dental health information which will help you to insure that your child has good dental health.

DR. CALIA M. MZABALINDA Department of Health