This patient initially presented with a history of early primary tooth loss, resulting in severe dental crowding and a blocked out permanent pre-molar. You can see from the initial photos, the black arrow is pointing to where the pre-molar should erupt. However, since a primary molar was lost early, there was nothing to maintain the space and the adjacent teeth drifted together. Early detection and orthodontic treatment is key in order to create space for the developing permanent tooth, prevent tooth impaction and minimize root damage. Notice how after just 5 months of progress in braces, the space has opened up and the once blocked out tooth is now well on its way towards perfect alignment.