Why Treat Baby Teeth for Decay?

One of the most common conversations I have with my patients’ 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.

Tooth decay in baby teeth

Since the enamel in primary teeth is thinner than in adult teeth, childhood cavities can spread quickly as they work their way toward the pulp (nerve and blood vessel) of the tooth. As the cavity deepens, painful sensitivity can develop which progresses to spontaneous, often severe, pain as the pulp becomes infected.  Without treatment, these infected teeth often lead to dental abscesses which require extraction of the involved teeth, and in severe situations may lead to facial infection and hospitalization.  In some situations, orthodontic problems arise after extractions when neighboring teeth drift into the extraction site and limit the space available for eruption of permanent teeth.


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 Pediatric Dentistry 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.

Thanks for reading, and please don’t hesitate to contact us with any questions,
Evan Shaw, DMD

You want me to floss my baby’s teeth?

Every day we have conversations like this in our office.  Don’t you already have enough to do as the parent of a toddler without trying to floss a squirming child’s teeth?

We put so much emphasis on flossing because we know where the real dental problems in children start, and we know what it will take to repair the damage of decay between the baby teeth.  (They are only called baby teeth because you get them as a baby.  They have to last until early teens.)

I wish I could tell you it’s unusual to see 4 or 5 year old children with decay between their molars, but it’s not.  And it’s not just children who eat candy or sticky sweets or don’t have their teeth brushed.  There are factors you can control like flossing and diet, and things you can’t control like heredity, type of bacteria and consistency of saliva, all of which play a part in the decay process.

So we focus on what you can control and without question the number one habit that pays off your entire life is flossing daily.

Unfortunately, most people don’t get this habit until after they’ve acquired a mouth full of fillings, or are dealing with gum issues. Then the treatment is not as simple as just flossing to keep your teeth for a lifetime.  Remember, that a lifetime is a lot longer than it was a hundred years ago.

The best way to give your child this habit is to introduce it right from the start and BE CONSISTENT.  You don’t let them wear a seatbelt only when you plan to go fast or far.  Sporadic flossing only gives your child the message that it’s not as important as brushing, and the fact is, that in the long run, it’s probably more important.

I’d rather see a 12 year old who flosses once a day and brushes once a day than one who brushes 3 or 4 times a day and only flosses occasionally because I know in the long run that  the flosser will have far fewer preventable dental problems, not only now, but for their entire life.

So while I’m an advocate on picking your battles with your children, this is one you really want to win.  Don’t worry about how well you floss a baby’s teeth, just get them used to it.  Once the molars are in all the way and it really matters, it should be an easy part of the daily routine.

At our first visits, we don’t just talk about this.  We show you how easy this important daily task can be.

Dr. Neale Eckstein