[Spontaneous loss of permanent teeth in children is never innocent]. / Spontaan verlies van een blijvend gebitselement op kinderleeftijd is nooist onschuldig.

A 13-year-old patient spontaneously lost tooth 47. In addition, he had for several weeks experienced numbness of the lower lip and the chin on the right side, fatigue, weakness, loss of appetite, and weight loss. After extensive investigation he seemed to be suffering from a Burkitt lymphoma. Spontaneous loss of permanent teeth in children has an extensive differential diagnosis. Dentists should be familiar with this differential diagnosis as all possible diagnoses are related to serious pathologies. The differential diagnosis includes infectious, metabolic, naplastic, and odontogenic causes. Systematic history taking, physical examination and laboratory investigations will lead to a proper diagnosis.