The effect of the premature loss of deciduous canines and first and second molars on malocclusion of the permanent dentition was studied in 255 schoolchildren 11 years of age or older at the most recent examination of the permanent dentition. Malocclusion was evaluated by scoring malalignment (major and minor) and measurement of crowding in the anterior teeth. Children who had a premature loss of one or more canines or molars had a higher frequency of receiving orthodontic treatment of one type or another for the permanent dentition. The likelihood of need of treatment increased with the number of prematurely lost teeth. Children who had lost one or more deciduous teeth through age 9 had a greater than threefold increase in the frequency of orthodontic treatment relative to the control. Of those who did not receive orthodontic treatment, there was no detectable relationship of the premature loss of canines with the malalignment of permanent teeth. However, there was a significant effect of the premature extraction of molars on malalignment especially major malalignment of permanent teeth. No differences were noted in their effects between the first and second deciduous molars. Crowding of the anterior teeth was directly affected by the premature loss of deciduous canines.