Cavities on baby teeth, do they really need to be fixed?

I often get questioned by parents on this topic.  If baby teeth will eventually fall out on their own, why do they need to be fixed?  Here are the four reasons that I give from the perspective of a board certified pediatric dentist in Las Vegas:

1.  Some baby teeth stay in the mouth for a long long time.  There are a total of 20 primary teeth (baby teeth).  Rather than falling out all together in a short amount of time, their exfoliation (falling off) follows a chronological order over 6 years of time.  Children often start to lose teeth around the age of 5 1/2 to 6 then lose their last tooth around 11 or 12 years old.  The incisors (front teeth) usually fall out first then the molars (big teeth in the back) fall out last.  So if a 3yo child comes in with 2 cavities on her molars we definitely need to restore them because those teeth need to last another 9 years!  Along the same logic, if a 6 yo child comes in with 2 cavities in the front it would make sense to either leave them alone or extract those teeth if the parents are sick of looking at the cavities.

2.  Cavities are not static, they’re always getting bigger.  When the cavity is limited to the enamel (superficial surface layer of the tooth), sometimes the cavity can stay the same size or even heal itself.  But once it’s into the dentin layer, cavities continue to grow and get bigger and bigger.  The rate of increase is often very rapid in children due to limited oral hygiene, size of the tooth, and frequent sugar exposure.  What may look like a small brown spot this year very often turn into a big hole the following year.

3.  It is much easier to restore teeth when the decay is small (fillings) than to fix big cavities (nerve treatments and crowns).  A lot of time untreated large cavities can infect the nerve and cause and infection or abscess, by then we have no choice other than extracting the tooth.  Fillings are also easier on the wallet for the parents.

4.  Primary teeth (baby teeth) not only serve their purpose in chewing, speech, and esthetics; they also maintain proper position of all the adjacent teeth in the area.  If we extract a back molar, the space that’s left after the extraction would cause the adjacent teeth to shift in position resulting in misalignment.  Often times a space maintainer (ie band and loop, Nance appliance, or lower lingual holding arch) needs to be put in after an extraction to prevent shifting of other teeth.  Something like that would have been prevented if the cavities were detected and treated earlier to avoid the extraction.

To put it simply: YES cavities on baby teeth for sure need to be fixed!

If you have any questions or concerns regarding dental treatments for baby teeth, please feel free to contact me at my Las Vegas pediatric dental office (702)242-2436