One of the most common conversations I have with my children patient’s parents is about why we restore cavities on baby teeth when we know that they will eventually be lost. Of course there are times when we may decide to “watch” a cavity based on the expectation that the tooth in question will fall out naturally before a problem develops, but many primary teeth are not lost until age 12 or 13 (on average). In many cases we are driven to treat cavities in primary teeth when they increase your child’s risk for pain, infection, or orthodontic (space) problems.
On the surface it may seem like a waste of time and effort to keep baby teeth when they are going to fall out. And certainly no young child wants to have a filling when they could get away without it. Nor does any parent want to see their child suffer from a toothache or other dental pain.
For some baby teeth this thinking is valid, but in reality all baby teeth are not of equal importance. While mum and dad may think the front teeth are the most important teeth in their child’s mouth, to a dentist the very back baby teeth are the critical ones to keep.
A baby tooth usually remains in the child’s mouth until a permanent tooth underneath it is ready to emerge through the gums. The roots of the baby tooth dissolve and the tooth becomes loose and falls out. The permanent tooth “comes up” a few weeks later. If a child loses a tooth too early–before the permanent tooth is ready to erupt–or if it is accidentally knocked out, or is removed by the dentist because of disease, the space must be saved. A space maintainer is inserted to take the place of the “baby tooth” until the permanent tooth is ready to emerge.
The space maintainer is a small metal device that encircles the tooth and the space to be saved. It “holds” the space until the permanent tooth is ready to erupt, stopping the other teeth from tipping or drifting into the empty space.
By caring for your milk teeth and treating them for cavities we can prevent infections like abscess and cysts. We see a lot of children suffering from cysts due to lack of oral hygiene and failure to get treatment done for cavities.
The reason for this is not because we dentists don’t care about children having a beautiful smile, it’s more that we have in mind the longer-term good of the child.
This explanation is not meant to scare anyone into seeking dental treatment and I’m not saying that children with severe cavities will all end up in braces, but I believe that it is important to understand that childhood dental decay is a serious problem that we are committed to helping control. You can be confident that at Crown Corner we know that each child’s situation is unique and that any treatment proposed is based on what we believe to be in his or her best interest.